title: Hemolytic anemia with aortic stenosis resolved by urgent aortic valve replacement.
abstract: A 78-year-old man with aortic stenosis complained of dark colored urine followed by recurrent chest pain and syncopal episodes. Echocardiography showed severely calcified aortic stenosis with the maximal pressure gradient of 125 mm Hg. Hemoglobin was 7.9 g/dL, lactate dehydrogenase was 2,295 IU/L, haptoglobin was less than 10 mg/dL, reticulocyte count was elevated, and Coombs' test was negative. We performed an urgent aortic valve replacement. After the surgery, the patient's urine became clear and his chest pain and syncope abated. All laboratory data returned to normal physiological values. In conclusion, the observed hemolysis was related to the aortic shear stress of a calcified aortic valve.
authors.affiliation: Department of Cardiovascular Surgery, Mie Heart Center, Taki-gun, Mie, Japan. ikaw63@hotmail.com
authors.forename: Isamu
authors.initials: I
authors.lastname: Kawase
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Matsuo
authors.forename: Koji
authors.initials: K
authors.lastname: Sasayama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Hideo
authors.initials: H
authors.lastname: Nishikawa
mesh_terms: D000368:Aged; D000743:Anemia, Hemolytic / Q000209:etiology*; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D002114:Calcinosis / Q000503:physiopathology; D002637:Chest Pain / Q000209:etiology; D004632:Emergency Medical Services; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D013314:Stress, Mechanical
chemical_list: D007770:L-Lactate Dehydrogenase