ID | 109593 |
Author |
Hara, Tomoya
Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
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Kishi-Tanaka, Kumiko
Department of Gastroenterology and Oncology, Institute of Health Biosciences, the University of Tokushima Graduate School
Iwase, Takashi
Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
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Yamada, Hirotsugu
Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
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Akaike, Masashi
Department of Medical Education, Institute of Health Biosciences, the University of Tokushima Graduate School
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Sata, Masataka
Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
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Keywords | diastolic heart failure
lower limb positive pressure test
apical hypertrophic cardiomyopathy
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Content Type |
Journal Article
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Description | A 70-year-old woman with dyspnea on exertion was admitted to our hospital. She had a history of apical hypertrophic cardiomyopathy (HCM) and repeated hospitalization for heart failure. Results of physical examination were normal except for leg edema. Echocardiography showed apical HCM with preserved LV systolic function (LVEF=70%). Although dyspnea on exertion and leg edema improved rapidly with the use of diuretics, her symptoms soon worsened when daily activity was started again. In order to examine the effect of preload on hemodynamics, we performed a lower limb positive pressure test by compressing both legs using a household air leg massager. Echocardiography showed increases in mitral E velocity, E/A ratio and pulmonary venous D flow as well as decrease in stroke volume during the lower limb positive pressure test. Simultaneously-recorded pressure study also showed elevated LVEDP and increased v wave of pulmonary capillary wedge pressure. These results suggested that even a small increase in preload led to elevation of LVEDP and symptomatic worsening due to severe diastolic heart failure in the present case. The lower limb positive pressure test may be useful for assessing the effect of preload on hemodynamics in patients with diastolic heart failure.
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Journal Title |
The journal of medical investigation : JMI
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ISSN | 13431420
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NCID | AA11166929
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Publisher | The University of Tokushima Faculty of Medicine
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Volume | 61
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Issue | 3-4
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Start Page | 404
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End Page | 408
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Sort Key | 404
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Published Date | 2014-08
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EDB ID | |
FullText File | |
language |
eng
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TextVersion |
Publisher
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departments |
University Hospital
Medical Sciences
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