J Cardiovasc Ultrasound.  2014 Sep;22(3):144-147. 10.4250/jcu.2014.22.3.144.

Multiple Cardiovascular Manifestations in a Patient with Autosomal Dominant Polycystic Kidney Disease

• Kang YR
• Ahn JH
• Kim KH
• Choi YM
• Choi J
• Park JR

• KMID: 2045431
• DOI: http://doi.org/10.4250/jcu.2014.22.3.144

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is a systemic disorder associated with various extrarenal complications. The major cardiovascular complications of ADPKD include valvulopathies and vascular ectasia. A 64-year-old man who was diagnosed with ADPKD seven years previously was admitted to our hospital for heart failure. Pelvic computed tomography revealed multiple variable-sized cysts in both kidneys. Transthoracic echocardiography showed enlargement of the left ventricle and left atrium. Severe mitral regurgitation and moderate aortic regurgitation with annuloaortic ectasia were observed. The left main coronary artery was dilated. The patient had various cardiovascular features associated with ADPKD.

Keyword

Cardiac manifestations; Autosomal dominant polycystic kidney disease; Heart failure

MeSH Terms

Aortic Valve Insufficiency
Coronary Vessels
Dilatation, Pathologic
Echocardiography
Heart Atria
Heart Failure
Heart Ventricles
Humans
Kidney
Middle Aged
Mitral Valve Insufficiency
Polycystic Kidney, Autosomal Dominant*

Figure

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  Fig. 1 Initial chest radiography. Chest radiography shows severe cardiomegaly and pulmonary congestion in both lung fields.

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  Fig. 2 Two-dimensional echocardiography. The left ventricular end-diastolic dimension/body surface area was approximately 44 mm/m2 and the left atrial volume index was calculated to be approximately 614 mL/m2 by the area-length method. Tethering and malcoaptation of the mitral valve are observed at end diastole. A: Parasternal long-axis view. B: Apical four-chamber view. LA: left atrium, LV: left ventricle.

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  Fig. 3 Transthoracic echocardiography. A: Eccentric and severe mitral regurgitation is observed on the parasternal long-axis view. B: Moderate aortic regurgitation is shown on the parasternal long-axis view. The size of the vena contracta is approximately 6 mm. C: The modified parasternal long-axis view shows annuloaortic ectasia. D: At the aortic valve level of the parasternal short-axis view, 15-mm dilatation of the left main coronary artery (arrows) is seen. LA: left atrium, Ao: aorta, AV: aortic valve.

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  Fig. 4 Abdominal computed tomography. Abdominal enhanced computed tomography shows multiple variable-sized cysts in both the kidney and liver. The abdominal aorta and branches are normal.

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