Acute efficacy of combined therapy of carperitide and nicorandil for acute decompensated heart failure with left ventricular systolic dysfunction.

A 64-year-old woman was admitted to our hospital with acute decompensated heart failure (ADHF) and left ventricular systolic dysfunction. Initial treatment with carperitide (0.01 µg/kg/min) had little effect. Since she had a borderline systolic blood pressure (i.e., a systolic BP between 90 and 110 mm Hg) and atrial fibrillation with a rapid ventricular response, nicorandil (0.1 mg/kg/h) was added to carperitide. This combined therapy achieved rapid improvement of ADHF. To our knowledge, this is the first report of a patient with ADHF and borderline systolic blood pressure in whom the combination of carperitide and nicorandil was safe and effective.

Acute efficacy of low-dose human atrial natriuretic peptide monotherapy without loop diuretics for acute decompensated heart failure with left ventricular systolic dysfunction: a case report.

A 64-year-old man was admitted to our hospital with new-onset acute decompensated heart failure (ADHF). He had left ventricular systolic dysfunction and chronic atrial fibrillation with a rapid ventricular response. Initial treatment with low-dose recombinant human atrial natriuretic peptide (hANP) alone and no loop diuretics had an immediate effect on ADHF and left ventricular systolic dysfunction. This case demonstrates that low-dose hANP (0.01 microg/kg/min) monotherapy can be safe and effective for ADHF, with no loop diuretics being required during hospitalization. However, clinical trials will be needed to further evaluate the acute efficacy and safety of hANP monotherapy in patients with ADHF.

[Primary effusion lymphoma complicating cardiac tamponade: a case report].

A 76-year-old woman was admitted to our hospital because of exertional dyspnea and leg edema during the previous month. Her systolic blood pressure on admission was 80 mmHg with 12 mmHg of pulsus paradoxous, and her pulse rate was 110 beats/min. Chest radiography revealed marked cardiomegaly and echocardiography showed massive pericardial effusion mainly behind the left ventricle and collapse of the right ventricle. The initial diagnosis was pericardial tamponade. Pericardiocentesis and pericardial drainage revealed bloody pericardial effusion. After drainage, her vital signs improved and her symptoms immediately disappeared. The cytological analysis of the pericardial effusion revealed numerous lymphoma cells. Computed tomography of the neck, chest and abdomen showed no evidence of tumor masses, lymph node enlargement, or hepatosplenomegaly. Infectious disease, collagen disease and aortic dissection were excluded. The final diagnosis was primary effusion lymphoma. The prognosis of primary effusion lymphoma is generally unfavorable because it is frequently accompanied by immunodeficiency disease. However, there was no human immunodeficiency virus infection in this patient. Fortunately, the effect of chemotherapy was excellent and the patient is doing well 1 year after the diagnosis.