Exercise testing induces fatal thromboembolism from mechanical mitral valve
Küçük Resim Yok
Tarih
2002
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Texas Heart Inst
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Thromboembolism is still one of the most important complications of prosthetic heart valves. Embolism to a major coronary branch is rare, but acute proximal occlusions can be fatal, even when the coronary arteries are otherwise normal and intervention is rapid. We report a fatal complication of an exercise test in a patient who had a St. Jude bileaflet mitral valve. After an exercise test, a 42-year-old woman with a mechanical prosthetic valve had a severe hemodynamic collapse with acute ST segment changes. Coronary angiography showed a totally occluded left main coronary artery with TIMI grade 0 to I flow. Rapid injection of contrast material and the passage of a floppy guidewire through the thrombus restored a TIMI grade 3 flow. Angiography showed no coronary atherosclerostic involvement. Despite successful coronary reperfusion, intra-aortic balloon counterpulsation, and intensive medication, the patient died. This case demonstrates that exercise testing should be applied with great caution in patients with prosthetic valves, and only after a careful evaluation of valve function, We recommend transesophageal echocardiography prior to exercise testing in these patients.
Açıklama
Anahtar Kelimeler
case report, coronary thrombosis/etiology, exercise test, female, heart valve prosthesis, middle age, mitral valve, myocardial infarction, prosthetic heart valves, thromboembolism/etiology
Kaynak
Texas Heart Institute Journal
WoS Q Değeri
N/A
Scopus Q Değeri
Cilt
29
Sayı
1
