Authors: Thomas Demming Norbert Frey Christoph Langer
Publish Date: 2013/05/15
Volume: 102, Issue: 8, Pages: 615-617
Abstract
Acute chest pain and progressive dyspnea led to the admission of an 83yearold female patient with known severely impaired left ventricular LV function and secondary mitral regurgitation II° due to dilated cardiomyopathy DCM Recurrent decompensations had led to cardiac resynchronization therapy via defibrillator CRTD implantation Present cardiovascular risk stratification revealed metabolic syndrome obesity diabetes mellitus type 2 arterial hypertension and hyperlipoproteinemia complicated by previous stroke whereas relevant coronary artery disease had been excluded years before Moreover recurrent exacerbating obstructive lung disease COLD GOLD III was reported and advanced renal failure was documented K/DOQI III serum creatinine 22 mg/dL urea 96 mg/dL glomerular filtration rate GFR MDRD 23 mL/min Initial clinical examination revealed wheezing over both lungs and mild edema of the lower limbs There was sinus rhythm at a normal heart rate and
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