A transfusion-related acute myocardial injury.
It is not uncommon for patients to have adverse reactions during or after blood transfusions, as they occur in 1%-6% of all blood transfusions. Although many of the reactions are clinically insignificant, a small subset of adverse reactions can lead to serious illness and even death. The authors describe a healthy young man who exhibited an acute pulmonary injury reaction to a blood product transfusion. However, he also suffered significant myocardial insult, as documented by decreased left ventricular ejection fraction and a significant rise in cardiac biomarkers. Based on current understanding of the pathophysiologic mechanisms in transfusion-related acute lung injury, the authors hypothesized that coronary endothelial injury may have caused microvascular ischemia or have induced acute myocarditis. Empiric treatment with steroids and a beta blocker resulted in improved left ventricular function in our patient.
Ramana
Ravi K
RK
Divison of Cardiology, Loyola University Medical Center, Maywood, IL 60153, USA. rkramana@earthlink.net
Helm
Robert
R
Moran
John F
JF
McKiernan
Thomas
T
D000208:Acute Disease; D000328:Adult; D006335:Heart Injuries / Q000209:etiology*; D006801:Humans; D055370:Lung Injury; D008297:Male; D013318:Stroke Volume; D065227:Transfusion Reaction