ニイナミ ヒロシ   NIINAMI Hiroshi
  新浪 博
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
論文種別 症例報告
言語種別 英語
査読の有無 査読あり
表題 Acute decompensated heart failure in a patient with primary aldosteronism successfully treated with an adrenalectomy: A case report.
掲載誌名 正式名:Journal of cardiology cases
略  称:J Cardiol Cases
ISSNコード:18785409/18785409
掲載区分国外
巻・号・頁 25(3),pp.140-143
著者・共著者 Imamura Yasutaka†, Suzuki Atsushi, Nomoto Michiru, Takano Mayu, Sawa Shintaro, Hoki Ryogo, Kikuchi Noriko, Yoshida Yusaku, Uto Kenta, Niinami Hiroshi, Hagiwara Nobuhisa
発行年月 2022/03
概要 Primary aldosteronism is often associated with heart failure (HF), and is reportedly difficult to treat in some cases. We report a case of severe HF associated with primary aldosteronism. A patient with HF, who was suspected of having primary aldosteronism, was referred to and examined at our hospital. After detailed examination, the patient was diagnosed with exacerbation of HF, and was treated at our department. Catheterization after admission revealed Forrester class IV HF. The patient was treated with catecholamine infusion in combination with medical treatment including mineralocorticoid receptor antagonists. The patient was diagnosed with hypertension due to primary aldosteronism and intractable secondary HF with increased peripheral vascular resistance. An open adrenalectomy was successfully performed under intra-aortic balloon pumping. Right heart catheterization, performed soon thereafter, demonstrated improvement in the patient's blood pressure and hemodynamics. We speculate that the improved cardiac function resulted from a reduction in the vascular resistance, as a consequence of the adrenalectomy. <Learning objective: Acute decompensated heart failure (HF) is one of the cardiovascular complications in patients with primary aldosteronism. However, there are few reports on the effective management of severe HF with concomitant primary aldosteronism. Although the appropriate time-frame for performing adrenalectomy remains undetermined, the procedure may effectively improve hemodynamics of patients with primary aldosteronism; this facilitates treatment of severe HF.>.
DOI 10.1016/j.jccase.2021.08.001
PMID 35261696