혈액투석 중 감염성 심내막염에 의한 건삭파열과 급성 승모판 폐쇄부전증 = Chordae Rupture and Acute Mitral Regurgitation Associated with Infective Endocarditis in a Patient Undergoing Hemodialysis

국문 초록 (Abstract)

혈액투석 환자에서 급성 폐부종은 흔하게 발생하는 합병증으로 주로 체액 과다 혹은 심부전증이 주요 원인이다. 심부전증은 주로 허혈성 심질환이나 좌심실비대 등에 의해 만성적으로 나타나나 본 증례와 같이 매우 드물게 감염성 심내막염에 의해 승모판 건삭파열과 급성 승모판 폐쇄부전증에 의해 발생할 수 있다. 그러므로 호흡곤란 등의 임상 증세 외에 고열과 염증 소견이 동반되는 경우에는 심초음파를 시행하여 감염성 심내막염과 이와 관련된 합병을 조기에 발견하여 치료해야 할 것으로 사료된다.

다국어 초록 (Multilingual Abstract)

Acute pulmonary edema in patients undergoing hemodialysis is a common cause of hospital admission and is often associated with fluid overload or congestive heart failure. Here, we report a rare case of chordae rupture and consequent severe mitral valve regurgitation due to infective endocarditis presenting as sudden onset pulmonary edema after properly conducted hemodialysis. (Korean J Med 2017;92:200-203)

참고문헌 (Reference)

1 Gabbay U, "The underlying causes of chordae tendinae rupture: a systematic review" 143 : 113-118, 2010

2 Abbott KC, "Hospitalizations for bacterial endocarditis after renal transplantation in the United States" 14 : 353-360, 2001

3 Bonow RO, "Guidelines for the management of patients with valvular heart disease:executive summary. A report of the American college of cardiology/American heart association task force on practice guidelines (Committee on Management of Patients with Valvular Heart Disease)" 98 : 1949-1984, 1998

4 Headley CM, "Flash pulmonary edema in patients with chronic kidney disease and end stage renal disease" 34 : 15-26, 2007

5 Kaymaz C, "Differentiating clinical and echocardiographic characteristics of chordal rupture detected in patients with rheumatic mitral valve disease and floppy mitral valve: impact of the infective endocarditis on chordal rupture" 6 : 117-126, 2005

6 Hoen B, "Changing profile of infective endocarditis: results of a 1-year survey in France" 288 : 75-81, 2002

7 Halle MP, "Acute pulmonary oedema in chronic dialysis patients admitted into an intensive care unit" 27 : 603-607, 2012