Torasemide-induced IgA vasculitis in a patient with heart failure

<正>Heart failure(HF) is a widespread clinical syndrome worldwide that imposes an enormous burden on healthcare systems.^[1,2] Loop diuretics are one of the cornerstones for treating HF, considering that extracellular fluid volume expansion plays a crucial role in the pathogenesis of congestive HF.^[3]     

Congestive heart failure in a patient with systemic hypertension

A 70-year-old man developed hypertension many years previously and had a bout with severe congestive heart failure 4 to 5 years before his death. Autopsy showed congestion and edema characteristic of heart failure, an enlarged heart, and slight focal interstitial left ventricular fibrosis, but only slight to moderate coronary atherosclerosis.     

Colchicine-induced rhabdomyolysis in a patient with chronic heart failure

Gout is a common co-morbidity in patients with chronic heart failure and its treatment is complex. We report the case of a 58-year-old man with chronic severe heart failure who developed rhabdomyolisis after short-term intake of colchicine. Although colchicine is a highly effective therapy for acute gouty arthritis, the dosage should be carefully titrated in patients with chronic heart failure, especially if renal or liver disease are also present.     

Reversible renal failure after combined treatment with enalapril and frusemide in a patient with congestive heart failure.

A patient with congestive heart failure and moderate renal insufficiency developed severe reversible non-oliguric renal failure while on frusemide and enalapril. Renal failure developed when enalapril was given in the presence of pronounced sodium depletion. When positive sodium balance was restored the plasma creatinine concentration began to fall while angiotensin converting enzyme inhibition remained effective and blood pressure was stable. These observations suggest that the degree of sodium depletion plays an important role in the tendency for angiotensin converting enzyme inhibitors to induce renal failure in patients with congestive heart failure and moderate renal insufficiency. Restoration of a positive sodium balance promotes the recovery of renal function after the combined administration of angiotensin converting enzyme inhibitors and diuretics.     

Severe right heart failure in a patient with grave's disease

This brief report presents a patient with isolated right heart failure and two rare underlying causes, hyperthy-roidism and dysplastic tricuspid valve. Repair of the tricuspid valve and treatment of the hyperthyroidism were both essential for successful treatment of the right heart failure. Most important, recrudescence of hyperthyroidism in this patient was associated with reappearance of florid right heart failure. This report provides further information about a potential linkage of hyperthyroidism and severe right heart failure.     

Disseminated tuberculosis--diagnostic difficulties in a patient with chronic heart failure

We presented case 64 year old patient with disseminated tuberculosis. The main symptom was fever and his death was due to respiratory and circulatory failure. In spite of extensive diagnostic research the aetiology of sepsis was not identified and the treatment was ineffective. In patients with severe disseminated tuberculosis the traditional diagnostic methods are often not effective.     

Management of new-onset congestive heart failure in a patient with complex congenital heart disease

The authors describe a 37-year-old African American female patient with congenital tricuspid stenosis, a secundum atrial septal defect, a ventricular septal defect, and subpulmonic stenosis whose only surgical intervention was a Glenn shunt procedure at the age of 11. She had been in reasonably good health for 26 years, but developed congestive heart failure. Her deteriorating clinical course was difficult to manage with only medical treatment, and cardiopulmonary transplantation is now being considered for the management of her complicated clinical condition.