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Novel expression of VCAM-1 on the mitral valve in a patient with primary antiphospholipid antibody syndrome
  1. M Sugutaa,
  2. Y Hoshinoa,
  3. S Naitob
  1. aThe Second Department of Internal Medicine, Gunma University School of Medicine, 3-39-15 Showamachi, Maebashi, Gunma 371-8511, Japan, bGunma Prefectural, Cardiovascular Center, Gunma
  1. Dr SugutaFast5150{at}

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A 48 year old Japanese man was admitted to our institute with orthopnoea. He had undergone coronary angioplasty for acute myocardial infarction six months before and had not had a follow up since that time. A chest radiograph showed severe pulmonary vascular congestion. No significant coronary lesions were seen on coronary angiography. Detailed transoesophageal echocardiography revealed a thickened mitral leaflet with poor coaptation with severe regurgitation, and a dilated left atrium (Fig 1A). Left ventricular function was preserved (ejection fraction 50%). Laboratory testing revealed thrombocytopenia and the presence of serum lupus anticoagulant …

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