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Acute Heart Failure in an Almost-Centenarian Patient With Symptomatic Severe Aortic Stenosis Treated With Ivabradine
Hiroki Sato1,2, Hidekazu Kondo1, Takahiro Oniki1,3
1Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN.
Abstract:
We report the case of a 99-year-old woman with acute chest pain caused by myocardial ischemia due to severe aortic stenosis (AS) and severe anemia. Red blood cells were transfused; however, this increased the preload and worsened pulmonary congestion. Treatment with drugs and non-invasive positive pressure ventilation could not sufficiently improve the pulmonary congestion. Ivabradine was administered to control the resting heart rate, following which the pulmonary congestion significantly improved. Ivabradine is a promising drug for acute heart failure of patients with AS by improving cardiac output by prolonging the left ventricular diastolic filling time without a negative inotropic effect.
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