- 著者
- Tomohiro Kaneko Sakiko Miyazaki Takuma Koike Azusa Murata Ryoko Morimoto Kuniaki Hirose Kazuhisa Takamura Daisuke Endo Atsushi Amano Tohru Minamino
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.8176-21, (Released:2021-10-19)
- 参考文献数
- 14
Atypical Shone's complex is a rare congenital anomaly involving a left-sided obstructive lesion of two or three cardiovascular levels. A 70-year-old man with dyspnea on exertion was diagnosed with severe aortic stenosis (AS) with a bicuspid valve, complicated by severe aortic coarctation (CoA) and a double-orifice mitral valve. He underwent surgery for AS and CoA in one session. It is important to search for complicated malformations, even in cases of bicuspid aortic valve found in old age.
- 著者
- Yuji Nishizaki Shinichiro Yamagami Hitoshi Sasano Eiryu Sai Kazuhisa Takamura Toshiki Nakahara Yoshiaki Furukawa Hiroyuki Daida
- 出版者
- 日本プライマリ・ケア連合学会
- 雑誌
- General Medicine (ISSN:13460072)
- 巻号頁・発行日
- vol.16, no.1, pp.41-44, 2015-03-20 (Released:2015-03-27)
- 参考文献数
- 6
A 91 year-old male who was orally receiving dabigatran and digitalis for chronic arterial fibrillation was hospitalized for cerebral infarction (CI). The complications of anemia due to gastrointestinal bleeding and the development of renal failure were also found, which enhanced the effect of digitalis. This enhanced drug action induced bradycardia and hypotension. The hypotension was improved by implanting a temporary pacemaker, and the neurological abnormal findings also disappeared with the improved blood pressure. In many cases, dabigatran is efficient in preventing CI, but in our case it in fact triggered a CI hemodynamically due to bradycardia and hypotension with gastrointestinal bleeding.