title: Hypertensive Crisis and Left Ventricular Thrombi after an Upper Respiratory Infection during the Long-term Use of Oral Contraceptives.
abstract: A 34-year-old woman who had been using oral contraceptives for 10 years developed hypertensive crisis with papilloedema after an upper respiratory infection. Laboratory data showed hyperreninemic hyperaldosteronism and elevated levels of fibrinogen, fibrin, and fibrinogen degradation products. Echocardiography demonstrated two masses (18 mm) in the left ventricle. On the fourth hospital day, cerebral infarction, renal infarction, and upper mesenteric artery occlusion suddenly occurred despite the blood pressure being well-controlled using anti-hypertensive drugs. Echocardiography revealed the disappearance of the left ventricular masses, which suggested left ventricular thrombi. Cessation of the contraceptives and administration of heparin, warfarin, and anti-platelets drugs improved her general condition.
authors.affiliation: Division of Nephrology and Rheumatology and Division of Cardiology, Department of Internal Medicine, Aichi Medical University School of Medicine, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Suzuki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Mizuno
authors.forename: Yukari
authors.initials: Y
authors.lastname: Kato
authors.forename: Norihiro
authors.initials: N
authors.lastname: Suga
authors.forename: Masabumi
authors.initials: M
authors.lastname: Yoshino
authors.forename: Naoto
authors.initials: N
authors.lastname: Miura
authors.forename: Shogo
authors.initials: S
authors.lastname: Banno
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Imai
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure; D003276:Contraceptives, Oral / Q000009:adverse effects; D004452:Echocardiography; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products; D005340:Fibrinogen; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D006493:Heparin; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000503:physiopathology*; D013927:Thrombosis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D003276:Contraceptives, Oral; D005338:Fibrin Fibrinogen Degradation Products; D014859:Warfarin; D005340:Fibrinogen; D006493:Heparin