Document Detail

Constrictive-like physiology in severe pulmonary hypertension: the effect of the Valsalva maneuver.
MedLine Citation:
PMID:  21606699     Owner:  NLM     Status:  MEDLINE    
We describe the case of a 37-year-old female with severe pulmonary hypertension on intravenous Remodulin and Tracleer who experienced presyncope following a six-minute walk. A transthoracic echocardiogram, in addition to showing the usual findings of chronic pulmonary hypertension, also demonstrated a noticeable increase in both mitral annular systolic and early diastolic (E') velocities while performing the Valsalva maneuver. Most importantly, a significant increase in the propagation velocity to an almost perpendicular tilt was noted with Valsalva, resembling the propagation velocity profile that has only been previously described in cases of constrictive pericarditis. The clinical relevance of this finding and the pathophysiologic implications are reviewed and discussed.
Angel López-Candales; Heather Cleary; Kathy Edelman
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Southern medical journal     Volume:  104     ISSN:  1541-8243     ISO Abbreviation:  South. Med. J.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-05-24     Completed Date:  2011-08-11     Revised Date:  2013-06-18    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  282-4     Citation Subset:  AIM; IM    
Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA 15213-2582, USA.
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MeSH Terms
Antihypertensive Agents / therapeutic use
Constriction, Pathologic
Epoprostenol / analogs & derivatives,  therapeutic use
Exercise Test
Hypertension, Pulmonary / drug therapy,  physiopathology*,  ultrasonography
Sulfonamides / therapeutic use
Valsalva Maneuver / physiology*
Reg. No./Substance:
0/Antihypertensive Agents; 0/Sulfonamides; 0/treprostinil; 35121-78-9/Epoprostenol; Q326023R30/bosentan
Comment In:
South Med J. 2011 Apr;104(4):284-5   [PMID:  21606700 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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