Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Refractory High Output Heart Failure in a Patient with Primary Mitochondrial Respiratory Chain Disease
Hitoshi NakagawaSatoshi OkayamaDaisuke KamonTomoya NakanoKenji OnoueRika KawakamiManabu HoriiYasuhiro SakaguchiShiro UemuraGenzou TakemuraYoshihiko Saito
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JOURNALS OPEN ACCESS

2014 Volume 53 Issue 4 Pages 315-319

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Abstract

A 40-year-old man who was referred to our hospital due to dyspnea was found to have high output cardiac failure on Swan-Ganz catheterization. An endomyocardial biopsy revealed cardiomyocyte hypertrophy with a vacuolar structure consistent with mitochondrial disease (MD). The patient was discharged, then readmitted for high output cardiac failure with hypotension and hyperlactacidemia. Treatment with cardiopulmonary support and hemodiafiltration gradually improved his general condition, although it resulted in ischemic necrosis of the right leg. The hyperlactacidemia completely resolved after amputation, and the high output cardiac failure has not recurred for two years. High output cardiac failure is rare in MD patients and is related to myocardial abnormalities and hyperlactacidemia.

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© 2014 by The Japanese Society of Internal Medicine
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