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dc.creatorCastro G,Pablo
dc.creatorVenegas A,Reinaldo
dc.creatorFardella B,Patricia
dc.creatorPérez P,Osvaldo
dc.creatorJalil M,Roberto
dc.creatorGutiérrez,Miguel A
dc.date2003-09-01
dc.date.accessioned2020-02-17T15:33:39Z
dc.date.available2020-02-17T15:33:39Z
dc.identifierhttps://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000900010
dc.identifier.urihttps://revistaschilenas.uchile.cl/handle/2250/130883
dc.descriptionA 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
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dc.languagees
dc.publisherSociedad Médica de Santiago
dc.relation10.4067/S0034-98872003000900010
dc.rightsinfo:eu-repo/semantics/openAccess
dc.sourceRevista médica de Chile v.131 n.9 2003
dc.subjectAntiphospholipid syndrome
dc.subjectHeart failure
dc.subjectLupus coagulation inhibitor
dc.titleSíndrome antifosfolípido catastrófico y falla cardíaca aguda: Caso clínico


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