iloprost and Pneumothorax

Systemic artery to pulmonary artery fistulas (SA-PAFs), are extremely rare in people without congenital heart disease. In this group of patients pulmonary arterial hypertension was reported in the single case. Then, we describe a case of multiple SA-PAFs, which were the cause of severe nonreversible arterial pulmonary hypertension in a patient who had a right-sided pneumothorax 35 years earlier.. 52-year-old male Caucasian patient with echocardiographically confirmed pulmonary hypertension (PH) was admitted to cardiology department due to exertional dyspnea and signs of right ventricle failure. Routine screening for causes of secondary PH was negative. Right heart catheterization (RHC) confirmed a high degree arterial PH [mean pulmonary artery pressure (mPAP); 50,6 mmHg, pulmonary wedge pressure (PWP); 11,3 mmHg, pulmonary vascular resistance (PVR); 11,9 Wood's units (WU)] irreversible in the test with inhaled nitric oxide. Oxygen saturation (SaO. Non-congenital SA-PAFs are extremely rare, however, they should be excluded in patients with pulmonary arterial hypertension and history of inflammatory or infectious disease of the lung and pleura, pneumothorax, cancer or Takayashu's disease and after chest trauma.

Topics: Arterio-Arterial Fistula; Cardiac Catheterization; Computed Tomography Angiography; Familial Primary Pulmonary Hypertension; Fatal Outcome; Heart Failure; Humans; Iloprost; Lung; Male; Middle Aged; Pneumothorax; Pulmonary Artery; Pulmonary Wedge Pressure; Sildenafil Citrate; Vascular Resistance

Topics: Drug Administration Schedule; Electrocardiography; Fatal Outcome; Female; Heart Failure; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Hypertension, Pulmonary; Iloprost; Infant, Newborn; Intracranial Aneurysm; Male; Nitric Oxide; Oxygen; Pneumothorax; Respiration, Artificial; Vasodilator Agents