A Case of Cardiogenic Shock due to Propionic Acidemia-Associated Cardiomyopathy Successfully Treated with a Combination of Mechanical Circulatory Support and Medical Therapy

  • Ishikawa Yusuke
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Fujino Takeo
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University Department of Advanced Cardiopulmonary Failure, Graduate School of Medical Sciences, Kyushu University
  • Hashimoto Toru
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Shinohara Keisuke
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Matsushima Shouji
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Fuke Yoshifumi
    Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University
  • Ushijima Tomoki
    Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University
  • Sonoda Hiromichi
    Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University
  • Nakashima Yu
    Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University
  • Mushimoto Yuichi
    Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University
  • Ishii Kanako
    Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University
  • Ide Tomomi
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Tsutsui Hiroyuki
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University School of Medicine and Graduate School, International University of Health and Welfare
  • Kinugawa Shintaro
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Shiose Akira
    Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University
  • Abe Kohtaro
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University

Description

<p>An 18-year-old man experienced refractory cardiogenic shock due to dilated cardiomyopathy of unknown aetiology, and was referred to our hospital to undergo a paracorporeal left ventricular assist device (LVAD) implantation. After surgery, the patient lost consciousness, with subsequent head computed tomography revealing low-density areas in the bilateral basal ganglia. Metabolic acidosis and hyperammonaemia also appeared. Metabolic evaluation and genetic tests led to a diagnosis of propionic acidemia. Following appropriate management of heart failure and propionic acidemia, his neurological and cardiac functions gradually recovered, and the paracorporeal LVAD was successfully explanted. Dilated cardiomyopathy and heart failure are rare manifestations of adult-onset propionic acidemia. This is the first reported case of cardiogenic shock due to propionic acidemia-associated cardiomyopathy successfully treated with a combination of mechanical circulatory support and medical therapy for heart failure and propionic acidemia.</p>

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