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Related Experiment Videos

Intravascular hemolysis in aortic stenosis.

Akihiro Tsuji1, Masaki Tanabe, Katsuya Onishi

  • 1First Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu 514-8507.

Internal Medicine (Tokyo, Japan)
|December 4, 2004
PubMed
Summary

Severe aortic stenosis can cause intravascular hemolysis, a condition where red blood cells break apart within blood vessels. Aortic valve replacement effectively resolved this hemolysis in a patient with severe aortic stenosis.

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Area of Science:

  • Cardiology
  • Hematology

Background:

  • Rheumatic aortic stenosis is a significant valvular heart disease.
  • Severe aortic stenosis can present with varied clinical manifestations.

Observation:

  • A 67-year-old woman with a 20-year history of rheumatic aortic stenosis presented with severe aortic valve stenosis (transvalvular pressure gradient >150 mmHg).
  • The patient exhibited symptoms of anemia, mild chronic renal failure, and laboratory findings indicative of intravascular hemolysis, including fragmented erythrocytes on peripheral blood smear, low hemoglobin, elevated lactate dehydrogenase, undetectable haptoglobin, and hemosiderinuria.

Findings:

  • The clinical presentation and laboratory results led to a diagnosis of intravascular hemolysis secondary to severe aortic stenosis.
  • Following successful aortic valve replacement, the fragmentation of erythrocytes on peripheral blood smear resolved dramatically.

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Implications:

  • This case highlights the association between severe aortic stenosis and hemolytic anemia.
  • Aortic valve replacement is an effective treatment for resolving hemolysis in patients with severe aortic stenosis.
  • Early recognition and intervention are crucial for managing complications of severe aortic stenosis.