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Chest pain in a heart transplant recipient:A case report
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作者 Yu-Jen Chen Chien-Sung Tsai Tsai-Wang Huang 《World Journal of Clinical Cases》 SCIE 2021年第16期3966-3970,共5页
BACKGROUND Heart transplantation is recommended for the treatment of patients with refractory heart failure.Chest pain after heart transplantation is usually considered noncardiac owing to the denervated heart.However... BACKGROUND Heart transplantation is recommended for the treatment of patients with refractory heart failure.Chest pain after heart transplantation is usually considered noncardiac owing to the denervated heart.However,data from case reports on tacrolimus-induced achalasia after heart transplantation are limited.We aimed to present a case of tacrolimus-induced achalasia that developed after heart tran-splantation,which was successfully relieved by laparoscopic Heller myotomy.CASE SUMMARY A 67-year-old man with a history of Type 2 diabetes mellitus,hyperlipidemia,and dilated cardiomyopathy had congestive heart failure following orthotopic heart transplantation with tacrolimus treatment 12 years ago.At the 10-year follow-up after the heart transplantation,the patient presented with persistent cough,dysphagia,heartburn,and retrosternal chest pain lasting for 2 wk.Upper endoscopy revealed no specific findings.Two years later,the patient experienced the same symptoms,including chest pain lasting for 4 wk.Esophagogram and manometry confirmed the presence of achalasia.Previous reports showed that discontinuing calcineurin inhibitor(CNI)treatment and endoscopic botulinum toxin injection could treat CNI-induced achalasia.Owing to the risk of rejection of the transplanted heart and considering the temporary benefits of botulinum toxin injection in achalasia,the patient underwent laparoscopic Heller myotomy.Dysphagia was relieved without complications.Eight months later,he had no signs of recurrence of the achalasia.CONCLUSION In transplant patients with chest pain and gastrointestinal symptoms, CNIinducedachalasia may be one of the differential diagnoses. Esophagogram/manometry is useful for diagnosis. 展开更多
关键词 heart transplantation refractory heart failure Chest pain ACHALASIA ESOPHAGOGRAM Case report
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COMBINED THERAPY OF CAPTOPRIL AND SPIRONOLACTONE FOR REFRACTORY CONGESTIVE HEART FAILURE
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作者 韩雅玲 余铭 +2 位作者 荆全民 胡小玲 刘际清 《Chinese Medical Journal》 SCIE CAS CSCD 1994年第9期50-54,共5页
It is traditionally considered that angiotensin-converting enzyme inhibitor(ACEI) and spironolactone could not be used simultaneously because of the assumed risk of hyperkalemia.
关键词 ALD ANP ACEI COMBINED THERAPY OF CAPTOPRIL AND SPIRONOLACTONE FOR refractory CONGESTIVE heart failure
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