Open AccessPulmonary hypertension: Tortuous route to diagnosis
Author(s) -
Riolo Giovanna,
Al Ghamdi Bader,
D'Arsigny Christine L.
Publication year - 2013
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.5
Subject(s) - presyncope , medicine , pulmonary hypertension , sildenafil , pulmonary wedge pressure , cardiology , cardiac catheterization , fistula , vascular resistance , blood pressure , hemodialysis , pulmonary artery , surgery , heart rate
A 47 year‐old woman, on hemodialysis via an arteriovenous (AV) fistula, was assessed for severe dyspnea and presyncope secondary to pulmonary hypertension. Right heart catheterization confirmed a mean pulmonary arterial pressure of 85 mm Hg. She had a normal wedge pressure. Investigations revealed that the total high cardiac output AV fistula, 8.3 L/min, resulted in pulmonary arteropathy and increased pulmonary vascular resistance at 674 dyne.sec.cm ‐5 . The AV fistula was banded and Sildenafil was prescribed, which resulted in improvement of pulmonary hypertension within one week.