Document Detail


Successful up-front combination therapy in a patient with idiopathic pulmonary hypertension and patent foramen ovale: an alternative to epoprostenol therapy?
MedLine Citation:
PMID:  19481029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pulmonary arterial hypertension (PAH) is a life-threatening disease of the pulmonary arterioles, which, in the absence of effective therapy, progresses rapidly to right heart failure and death. Opening of a patent foramen ovale (PFO) is common in patients with severe pulmonary hypertension (PH), resulting in resistive hypoxemia. We report the case of a 40-year-old woman with idiopathic pulmonary hypertension (iPAH) in New York Heart Association (NYHA) class III to IV, who was admitted in the intensive care unit with hemodynamic compromise and severe hypoxemia due to right-to-left shunt throughout a PFO. Combination therapy initially with inhaled iloprost and sildenafil, and then addition of an endothelin A receptor-selective antagonist (sitaxsentan), resulted in impressive improvement in oxygenation with reversal of the right-to-left shunt and marked improvement in functional class of the patient.
Authors:
Georgia G Pitsiou; Nikolaos Chavouzis; Chrysanthi Nakou; Afroditi K Boutou; Paraskevi Argyropoulou; Ioannis Stanopoulos
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  28     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-01     Completed Date:  2009-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  651-3     Citation Subset:  IM    
Affiliation:
Respiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / therapeutic use
Drug Therapy, Combination
Epoprostenol / therapeutic use*
Female
Foramen Ovale, Patent / complications,  diagnosis,  drug therapy*
Humans
Hypertension, Pulmonary / complications,  diagnosis,  drug therapy*
Iloprost / therapeutic use*
Isoxazoles / therapeutic use*
Piperazines / therapeutic use*
Purines / therapeutic use
Receptor, Endothelin A / antagonists & inhibitors
Sulfones / therapeutic use*
Thiophenes / therapeutic use*
Treatment Outcome
Vasodilator Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Isoxazoles; 0/Piperazines; 0/Purines; 0/Receptor, Endothelin A; 0/Sulfones; 0/Thiophenes; 0/Vasodilator Agents; 0/sitaxsentan; 139755-83-2/sildenafil; 35121-78-9/Epoprostenol; 78919-13-8/Iloprost

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


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