RESUMEN
A 90-year-old man presented with subcutaneous ecchymoses. He had been under treatment with dabigatran etexilate methanesulfonate (DEM). Prolonged APTT and decreased PT was developed 2 months after the start of DEM, more prolonged 6 months later. DEM was discontinued, the coagulopathy did not improve. Factor V activity was decreased, along with appearance of coagulation factor V inhibitor (FVI). He did not have antiphospholipid syndrome or malignancy. He was diagnosed as having acquired FVI caused by DEM. Steroid pulse therapy was effective. There have been 74 reported cases of AFVI induced by drug treatment, but none after treatment with DEM.
Asunto(s)
Anemia Hemolítica Autoinmune/diagnóstico , Hipotiroidismo/diagnóstico , Enfermedades Pulmonares/diagnóstico , Síndrome Nefrótico/diagnóstico , Anciano de 80 o más Años , Anemia Hemolítica Autoinmune/complicaciones , Crioglobulinas/efectos adversos , Humanos , Hipotiroidismo/complicaciones , Enfermedades Pulmonares/etiología , Masculino , Síndrome Nefrótico/complicacionesRESUMEN
The first case was a 68-year-old woman who had acute migratory pain from back to anterior chest and the second case was 66-year-old man with a cardiac tamponade. Two cases were demonstrated with a low density area of the left ventricular postero-lateral wall with conventional contrast-enhanced computed tomography (CE-CT) performed to differentiate the diagnosis of acute coronary syndrome and acute aortic dissection. Subsequent coronary angiograms showed the lesions of left circumflex. These cases of early contrast-defect corresponded to a decreased myocardial blood flow with AMI. CE-CT image facilitated the diagnosis of AMI preceding CAG examination.
Asunto(s)
Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Infarto del Miocardio/complicaciones , Infarto del Miocardio/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Anciano , Femenino , Humanos , MasculinoRESUMEN
A 28-year-old man developed severe infundibular pulmonary stenosis (PS), coronary artery stenosis with sustained ventricular tachycardia (VT) 24 years after mediastinal irradiation (total amount of 40 Gray) for non-Hodgkin's lymphoma. Repair of right ventricular outflow tract and coronary artery bypass graft procedure were performed. Infundibular PS was successfully relieved after operation and VT was also controlled by medication. Mediastinal irradiation often causes various cardiac complications after a latent period. Therefore, continuous careful observation is mandatory in patients with the history of mediastinal irradiation.