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Adult patent ductus arteriosus complicated by endocarditis and hemolytic anemia.

Sabzi F, Faraji R - Colomb. Med. (2015)

Bottom Line: The case illustrated unique role of vegetation of endocarditis in hemolytic anemia in adult with patent ductus arteriosus (PDA).The 3-month follow-up revealed complete occlusion of PDA and abolishment of hemolytic anemia confirmed by clinical and laboratory examination.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Preventive Cardiovascular Research Centre Kermanshah, Kermanshah University of Medical Sciences, Kermanshah, Iran.

ABSTRACT
An adult with a large patent ductus arteriosus may present with fatigue, dyspnea or palpitations or in rare presentation with endocarditis. The case illustrated unique role of vegetation of endocarditis in hemolytic anemia in adult with patent ductus arteriosus (PDA). Despite treatment of endocarditis with complete course of appropriate antibiotic therapy and normality of C- reactive protein, erythrocyte sedimentation rate and leukocytosis and wellness of general condition, transthoracic echocardiography revealed large vegetation in PDA lumen, surgical closure of PDA completely relieved hemolysis, and fragmented red cell disappeared from peripheral blood smear. The 3-month follow-up revealed complete occlusion of PDA and abolishment of hemolytic anemia confirmed by clinical and laboratory examination.

No MeSH data available.


Related in: MedlinePlus

A. Vegetation in PDA extended to main pulmonary artery. B. Concomitant aortic valve calcification with large aortic diameter due to left to right shunt. C. Revealed vegetation in pulmonary side of PDA. D. Shows vegetation in pulmonary side of PDA.
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f01: A. Vegetation in PDA extended to main pulmonary artery. B. Concomitant aortic valve calcification with large aortic diameter due to left to right shunt. C. Revealed vegetation in pulmonary side of PDA. D. Shows vegetation in pulmonary side of PDA.

Mentions: In physical examination, the cardiac examination was not able for prominent grade 3/6 systolic murmurs best heard at the left upper sternal border in second inter costal space with radiation into the anterior left chest. Echocardiogram revealed the presence of a PDA in the setting of normal left ventricular function. However, it had a large diameter but a small shunt was not on TTE echocardiography that caused hemolysis. Transthoracic Echocardiogram showed the left ventricle with conserved systolic function, mild aortic insufficiency with calcified valve, and a fixed structure on the wall of the pulmonary artery with erratic movement indicative of vegetation on orifice of PDA (Figs. 1A and B). Transthoracic Echocardiogram suggested a large (10 mm) PDA with left to right shunt. Pulmonary artery mean pressure was 36 mm Hg, consistent with mild pulmonary hypertension (25-35 mm Hg). Moderate left and right atrial enlargement and a mildly enlarged main pulmonary artery were noted.


Adult patent ductus arteriosus complicated by endocarditis and hemolytic anemia.

Sabzi F, Faraji R - Colomb. Med. (2015)

A. Vegetation in PDA extended to main pulmonary artery. B. Concomitant aortic valve calcification with large aortic diameter due to left to right shunt. C. Revealed vegetation in pulmonary side of PDA. D. Shows vegetation in pulmonary side of PDA.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4536820&req=5

f01: A. Vegetation in PDA extended to main pulmonary artery. B. Concomitant aortic valve calcification with large aortic diameter due to left to right shunt. C. Revealed vegetation in pulmonary side of PDA. D. Shows vegetation in pulmonary side of PDA.
Mentions: In physical examination, the cardiac examination was not able for prominent grade 3/6 systolic murmurs best heard at the left upper sternal border in second inter costal space with radiation into the anterior left chest. Echocardiogram revealed the presence of a PDA in the setting of normal left ventricular function. However, it had a large diameter but a small shunt was not on TTE echocardiography that caused hemolysis. Transthoracic Echocardiogram showed the left ventricle with conserved systolic function, mild aortic insufficiency with calcified valve, and a fixed structure on the wall of the pulmonary artery with erratic movement indicative of vegetation on orifice of PDA (Figs. 1A and B). Transthoracic Echocardiogram suggested a large (10 mm) PDA with left to right shunt. Pulmonary artery mean pressure was 36 mm Hg, consistent with mild pulmonary hypertension (25-35 mm Hg). Moderate left and right atrial enlargement and a mildly enlarged main pulmonary artery were noted.

Bottom Line: The case illustrated unique role of vegetation of endocarditis in hemolytic anemia in adult with patent ductus arteriosus (PDA).The 3-month follow-up revealed complete occlusion of PDA and abolishment of hemolytic anemia confirmed by clinical and laboratory examination.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Preventive Cardiovascular Research Centre Kermanshah, Kermanshah University of Medical Sciences, Kermanshah, Iran.

ABSTRACT
An adult with a large patent ductus arteriosus may present with fatigue, dyspnea or palpitations or in rare presentation with endocarditis. The case illustrated unique role of vegetation of endocarditis in hemolytic anemia in adult with patent ductus arteriosus (PDA). Despite treatment of endocarditis with complete course of appropriate antibiotic therapy and normality of C- reactive protein, erythrocyte sedimentation rate and leukocytosis and wellness of general condition, transthoracic echocardiography revealed large vegetation in PDA lumen, surgical closure of PDA completely relieved hemolysis, and fragmented red cell disappeared from peripheral blood smear. The 3-month follow-up revealed complete occlusion of PDA and abolishment of hemolytic anemia confirmed by clinical and laboratory examination.

No MeSH data available.


Related in: MedlinePlus