Journal
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
Volume 39, Issue 4, Pages 532-535Publisher
SPRINGER
DOI: 10.1007/s11239-014-1134-x
Keywords
Mitral valve stenosis; Heme oxygenase; Fibrinogen; Iron; Carbon monoxide; Thrombelastography
Funding
- Department of Anesthesiology
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We present a case of a patient with calcific mitral valve stenosis and plasmatic hypercoagulability. Using thrombelastography, the patient was determined to have an abnormally large velocity of plasma thrombus growth and strength with reduced vulnerability to lysis. Critically, increased carboxyhemoglobin concentration (2.4 %) was present, likely secondary to hemolysis from mitral stenosis and engagement of systemic heme oxygenase. It was determined that the patient's plasmatic hypercoagulability was in part due to carboxyhemefibrinogen formation and iron-enhancement of coagulation via two thrombelastographic methods. In conclusion, future investigation of the involvement of both carbon monoxide and iron mediated hypercoagulability in the setting of stenotic valve disease is warranted.
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