title: Echocardiography findings in a case with Ballantyne syndrome.
abstract: Marked fluid retention occurs in Ballantyne syndrome, but few reports are available on changes in cardiac morphology in this syndrome. A woman with generalized edema, dyspnea, fetal hydrops (skin edema and ascites), thickened placenta, and elevated plasma B-type natriuretic peptide level (344 pg/mL) was admitted to our hospital at gestational week (GW) 20+3. Blood pressure remained within the normal range. However, acute increases in left atrial volume index, pulmonary artery systolic pressure, and hyperdynamic left ventricular function (as evidenced by increased left ventricular ejection fraction to 74% with cardiac index of 5.1 L/min/m2) occurred preceding fetal death at GW 21+4in the presence of increased inferior vena cava diameter (23 mm) and relatively low systemic vascular resistance of 752 dyn·s/cm5. These findings suggested life-threatening heart failure and required cesarean delivery at GW 21+5resulting in complete recovery. The placenta suggested cytomegalovirus infection.
authors.affiliation: Department of Obstetrics and Gynecology, Obihiro-Kosei General Hospital, Obihiro, Hokkaido, Japan.
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Obstetrics and Gynecology, Obihiro-Kosei General Hospital, Obihiro, Hokkaido, Japan.
authors.forename: Mie
authors.initials: M
authors.lastname: Yamamura
authors.affiliation: Department of Pathology, Obihiro-Kosei General Hospital, Obihiro, Hokkaido, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: Department of Obstetrics and Gynecology, Obihiro-Kosei General Hospital, Obihiro, Hokkaido, Japan.
authors.forename: Rifumi
authors.initials: R
authors.lastname: Hattori
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Umazume
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods*; D004487:Edema / Q000000981:diagnostic imaging*; D005260:Female; D005313:Fetal Death; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D013577:Syndrome
keywords: heart failure; renin-angiotensin-aldosterone system; soluble fms-like tyrosine kinase-1; triple edema syndrome