Síndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínico

A 33 years old woman was admitted to the hospital after four days with cough, dyspnea, orthopnea and hemoptysis. Blood pressure was 170/90 mmHg, pulse was 112 and temperature was normal. She had cyanosis and a left ventricular gallop, without heart murmurs. A chest radiograph revealed pulmonary edem...

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Autores principales:	Castro G,Pablo, Venegas A,Reinaldo, Fardella B,Patricia, Pérez P,Osvaldo, Jalil M,Roberto, Gutiérrez,Miguel A
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2003
Materias:	Antiphospholipid syndrome Heart failure Lupus coagulation inhibitor
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000900010
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spelling	oai:scielo:S0034-988720030009000102004-12-13Síndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínicoCastro G,PabloVenegas A,ReinaldoFardella B,PatriciaPérez P,OsvaldoJalil M,RobertoGutiérrez,Miguel A Antiphospholipid syndrome Heart failure Lupus coagulation inhibitor A 33 years old woman was admitted to the hospital after four days with cough, dyspnea, orthopnea and hemoptysis. Blood pressure was 170/90 mmHg, pulse was 112 and temperature was normal. She had cyanosis and a left ventricular gallop, without heart murmurs. A chest radiograph revealed pulmonary edema and echocardiogram showed a global left ventricular systolic disfunction. Oxygen and furosemide were started, but cardiopulmonary collapse ensued. The patient was supported with mechanical ventilation and treated with inotropic drugs. A right sided cardiac catheterization showed pulmonary wedge pressure of 18 mmHg and a cardiac index of 3 l/min/m². The levels of creatinine and urea nitrogen were elevated and a urine protein was 97 mg/dl. Coagulation tests were normal except by a positive lupic anticoagulant. Markers of connective tissue diseases or vasculitis were negatives. The clinical evolution suggested that a catastrophic antiphospholipid syndrome was ongoing. Intravenous corticoids, gammaglobulin and cyclofosfamide were administered with transient improvement. On her fourth day of treatment, the patient presented sudden pulmonary bleeding and embolism. A plasmapheresis was performed with improvement of renal, cardiac and pulmonary function. After this episode, the patient has been treated with prednisone and oral anticoagulants treatment for the last two years, without further clinical eventsinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.131 n.9 20032003-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000900010es10.4067/S0034-98872003000900010
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Antiphospholipid syndrome Heart failure Lupus coagulation inhibitor
spellingShingle	Antiphospholipid syndrome Heart failure Lupus coagulation inhibitor Castro G,Pablo Venegas A,Reinaldo Fardella B,Patricia Pérez P,Osvaldo Jalil M,Roberto Gutiérrez,Miguel A Síndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínico
description	A 33 years old woman was admitted to the hospital after four days with cough, dyspnea, orthopnea and hemoptysis. Blood pressure was 170/90 mmHg, pulse was 112 and temperature was normal. She had cyanosis and a left ventricular gallop, without heart murmurs. A chest radiograph revealed pulmonary edema and echocardiogram showed a global left ventricular systolic disfunction. Oxygen and furosemide were started, but cardiopulmonary collapse ensued. The patient was supported with mechanical ventilation and treated with inotropic drugs. A right sided cardiac catheterization showed pulmonary wedge pressure of 18 mmHg and a cardiac index of 3 l/min/m². The levels of creatinine and urea nitrogen were elevated and a urine protein was 97 mg/dl. Coagulation tests were normal except by a positive lupic anticoagulant. Markers of connective tissue diseases or vasculitis were negatives. The clinical evolution suggested that a catastrophic antiphospholipid syndrome was ongoing. Intravenous corticoids, gammaglobulin and cyclofosfamide were administered with transient improvement. On her fourth day of treatment, the patient presented sudden pulmonary bleeding and embolism. A plasmapheresis was performed with improvement of renal, cardiac and pulmonary function. After this episode, the patient has been treated with prednisone and oral anticoagulants treatment for the last two years, without further clinical events
author	Castro G,Pablo Venegas A,Reinaldo Fardella B,Patricia Pérez P,Osvaldo Jalil M,Roberto Gutiérrez,Miguel A
author_facet	Castro G,Pablo Venegas A,Reinaldo Fardella B,Patricia Pérez P,Osvaldo Jalil M,Roberto Gutiérrez,Miguel A
author_sort	Castro G,Pablo
title	Síndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínico
title_short	Síndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínico
title_full	Síndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínico
title_fullStr	Síndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínico
title_full_unstemmed	Síndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínico
title_sort	síndrome antifosfolípido catastrófico y falla cardíaca aguda: caso clínico
publisher	Sociedad Médica de Santiago
publishDate	2003
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000900010
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Síndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínico

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