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Laparoscopic Endoscopic Surgical Science Multipl Pulmoner Nodl Etiyolojisi: Mitral Stenoz [Respir Case Rep]
Respir Case Rep. 2013; 2(1): 6-9 | DOI: 10.5505/respircase.2013.08208

Multipl Pulmoner Nodl Etiyolojisi: Mitral Stenoz

Funda Aksu1, Alper Yurdasiper2, Serdar Akyz3
1Eskiehir Yunus Emre Devlet Hastanesi, Gs Hastalklar Klinii
2Eskiehir Yunus Emre Devlet Hastanesi, Radyoloji Klinii
3Eskiehir Yunus Emre Devlet Hastanesi, Kardiyoloji Klinii

Sekiz yl nce mitral kapak replasman operasyonu geirmi olan 36 yanda erkek hasta gs ars ile bavurdu. Fizik muayenesinde gs n duvarda sternotomi skar blgesinde ilik, kzarklk ve hassasiyet dnda patoloji saptanmad. Akcier grafisinde bilateral nodler dansiteler mevcuttu. Bilgisayarl toraks tomografisinde mitral kapak dzeyinde kalsifikasyon ve her iki akcierde dank yerleimli, bazlar kalsifiye ok sayda milimetrik nodller saptand. leri tetkiklerde multipl pul-moner nodl etiyolojisini aklayacak enfeksiyz, granulomatz ya da neoplastik bir patoloji sap-tanmad ve nodller ncelikle mitral stenoza sekonder dnld. Gs arsnn nedeni sternal tel batmas olarak saptand ve operasyonla tel eksize edildi. lk bavurusundan 16 ay sonra hasta hemoptizi ve iddetli gs ars nedeni tekrar bavurdu. Kardiyak deerlendirme ile hemoptizi ve pulmoner nodllerin mitral kapak replasman operasyonu sonras inefektif warfarin kullanmna bal sol atriyum basncnda ykselmelerle seyreden pulmoner konjesyona baland. Romatizmal kalp hastalklar lkemizde halen sk olarak grlmekte olup multipl pulmoner nodl etiyolojilerinde ayrc tanda dnlmelidir.

Anahtar Kelimeler: Mitral kapak darl, oklu akcier nodlleri, diopatik pulmoner hemosiderozis.

Etiology of Multiple Pulmonary Nodules: Mitral Stenosis

Funda Aksu1, Alper Yurdasiper2, Serdar Akyz3
1Eskiehir Yunus Emre Hospital, Deparment Of Chest Diseases
2Eskiehir Yunus Emre Hospital, Deparment Of Radiology
3Eskiehir Yunus Emre Hospital, Deparment Of Cardiology

A 36-year-old male patient, with a history of mitral valve replacement (MVR) operation eight years prior, was admitted with chest pain. A physical examination revealed no pathologies except swelling, redness, and sensitivity on the site of the scar tissue of a sternotomy. Bilateral nodular densities were detected in the chest X-ray. Computed tomography of the thorax revealed calcification at the site of the mitral valve and randomly distributed, multiple millimetric pulmonary nodules, some of which were calcified. Underlying infectious, granulomatous, or neoplastic pathologies were not detected upon further evaluation, and the nodules were accepted as secondary to mitral valve stenosis. Chest pain was due to sternal wire sutures and was completely resolved after removal of the sutures. Patient was readmitted with hemoptysis and severe chest pain 16 months after the first admission. Cardiac evaluation revealed that hemoptysis and the pulmonary nodules were caused by pulmonary congestion together with increases in the left atrial pressure, due to ineffective warfarin treatment after the MVR operation. Rheumatic heart diseases should be a part of the differential diagnosis in researching the etiology of pulmonary nodules, as they continue to be encountered frequently in Turkey.

Keywords: Mitral Valve Stenosis, Multiple Pulmonary Nodules, Idiopathic pulmonary hemosiderosis.

Funda Aksu, Alper Yurdasiper, Serdar Akyz. Etiology of Multiple Pulmonary Nodules: Mitral Stenosis. Respir Case Rep. 2013; 2(1): 6-9

Sorumlu Yazar: Funda Aksu, Trkiye
Makale Dili: Trke
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