ABSTRACT
Spontaneous echocardiographic contrast is well reported in states of low flow and low shear stress, and the primary blood component involved has been reported as red blood cells via rouleaux formation. This report describes the occurrence of spontaneous echocardiographic contrast from a unique mechanism of IgM-mediated red blood cell agglutination and describes the clinical sequelae.
Subject(s)
Anemia, Hemolytic, Autoimmune/diagnostic imaging , Antibodies, Anti-Idiotypic/immunology , Echocardiography , Erythrocyte Aggregation/diagnostic imaging , Immunoglobulin M/immunology , Anemia, Hemolytic, Autoimmune/immunology , Autopsy , Cardiac Output, Low/diagnostic imaging , Cardiac Output, Low/etiology , Child , Erythrocyte Aggregation/immunology , Fatal Outcome , Female , HumansABSTRACT
In 158 patients with chronic ischaemic heart disease (IHD), the state of microcirculation was investigated, using local 133Xe clearance. With growing severity of the disease, muscular blood flow decreased. Local disturbances were accompanied also by changes in central haemodynamics (decrease in cardiac index, slow-down of blood flow in the pulmonary and systemic circulations, increased peripheral resistance), which were established by radiocardiography using 131I-labelled albumin. A distinct relationship was found between muscular blood flow and the intensity of intravascular microcirculatory disturbances (microthrombosis, intravascular thrombocyte aggregation, arteriolo-venular anastomoses). The authors recommend the use of 133Xe clearance for microcirculation study in patients with chronic IHD.
