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Elevated preprocedural CRP is not associated with increased risk for CI-AKI in patients undergoing PCI
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Case History :

A 40 year male patient with no previous history of cardiac disease presented with rapid symptomatic deterioration (dyspnea and fatigue) over 2-3 months.And has shortness of breath with mild exertion (NYHA 3). He was a chronic smoker and has a history of"Polycythemia rubra vera" incorrectly diagnosed 18 months earlier treated with regular phlebotomy.
He's taken allopurinol for gout for two years.Pulse 100/minute; BP 140/95 mmHg.
Moderate cyanosis and clubbing of fingers and toes (saturation 70%)
JVP normal, no edema. Mild RV lift. Loud single second sound. Early systolic sound. Grade 2 ejection systolic murmur LSB.

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Investigation Reports :

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Discussion :

This man has Eisenmenger syndome. He is not a candidate for VSD repair alone. Iron supplementation is required because of iatrogenic iron deficiency and a relative anemia. He is seen as a candidate for eventual lung transplantation, although it's not clear (until his hemoglobin is corrected) how much of his recent deterioration was due to blood loss, and how much to progressive pulmonary vascular disease. Many of them will live until their 40s, 50s, and occasionally beyond. We would not wish to interface with such a prospect. Others will die suddenly without prior deterioration. Our focus is usually on quality of life, since markers for death are poorly defined. It should also be noted that outcome of transplantation in congenital heart disease are generally felt to be inferior to that of other conditions (e.g. dilated cardiomyopathy, CAD, primary lung disease).