RESUMO
A 57-year-old man developed transient global amnesia within an hour of bolus unfractionated heparin administration on day 4 post-mitral valve replacement. Both immunoglobulin G-specific enzyme-linked immunosorbent assay and serotonin release assay were strongly positive for the antibodies that cause heparin-induced thrombocytopenia. The patient's cognitive functions returned to normal following discontinuation of unfractionated heparin and warfarin and commencement of lepirudin infusion.
Assuntos
Amnésia Global Transitória/diagnóstico , Anticoagulantes/efeitos adversos , Heparina/efeitos adversos , Trombocitopenia/complicações , Varfarina/efeitos adversos , Amnésia Global Transitória/induzido quimicamente , Anticoagulantes/uso terapêutico , Implante de Prótese de Valva Cardíaca , Hirudinas , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/patologia , Proteínas Recombinantes/uso terapêutico , Trombocitopenia/induzido quimicamente , Fatores de TempoRESUMO
We describe a case of electromechanical dissociation (EMD) in a 62-year-old female patient following insertion of a Medtronic Hall mitral valve prosthesis. She initially developed pulsus alternans which led, over a few hours, to intermittent electromechanical dissociation. Clinical and echocardiographic findings are described. Emergency surgical intervention revealed a piece of chorda wedged between the disc occluder and the valve ring. This case illustrates clinical and Doppler echocardiographic features associated with a rare presentation of an unusual perioperative complication of prosthetic mitral valve dysfunction. We have also included a brief review of related literature.