A CASE OF DISSEMINATED INTRAVASCULAR COAGULATION (DIC) ASSOCIATED WITH CONGESTIVE HEART FAILURE

• Published in: Japanese Journal of National Medical Services Vol. 49; no. 9; pp. 756 - 760
• Main Authors: KAGEYAMA, Yo, KIMURA, Mitsuhiro, YATAGAI, Shigeo
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1995
• Subjects: congestive heart failure; disseminated intravascular coagulation
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.49.756

A case of disseminated intravascular coagulation (DIC) associated with congestive heart failure is reported. A 68-year-old woman was admitted to our hospital because of dyspnea and tarry stools. She first experienced dyspnea about 2 weeks earlier, then, her dyspnea worsened and tarry stools appeared, and she was transferred by ambulance. A bleeding tendency, tachycardia, cyanosis, consciousness disturbance and rales in her chest were noted. Laboratory examinations revealed cardiomegaly, thrombocytopenia, renal dysfunction, elongation of prothrombin time, increase in fibrin/fibrinogen degradation products, and decreases in fibrinogen and antithrombin III. Bone marrow aspiration showed normal cellularity, and morphological abnormality was not observed. Based on these findings, we diagnosed her condition as congestive heart failure complicated by DIC, then treated her with oxygen, diuretics and digoxin for congestive heart failure, and nafamostat mesilate for DIC. Her congestive heart failure, consciousness disturbance and bleeding tendency improved and renal dysfunction, thrombocytopenia and abnormalities in blood coagulation became normal after these treatments. DIC caused by congestive heart failure is rare; only 7 cases have been reported so far in the literature in Japan.