sildenafil-citrate and Shock--Cardiogenic

We report the case of a treatment-naive patient with pulmonary arterial hypertension who presented with decompensated right ventricular failure and cardiogenic shock. Unstable hemodynamics, hypoxia and end-organ hypoperfusion limited up-titration of pharmacotherapy. Mechanical circulatory support with veno-venous extracorporeal membrane oxygenation (VV-ECMO) was initiated to permit dose titration of pulmonary vasodilator therapy. VV-ECMO was weaned after 10 days of support, with successful transition to intravenous epoprostenol and oral sildenafil.

Topics: Administration, Oral; Adult; Antihypertensive Agents; Combined Modality Therapy; Epoprostenol; Extracorporeal Membrane Oxygenation; Female; Humans; Hypertension, Pulmonary; Injections, Intravenous; Piperazines; Purines; Shock, Cardiogenic; Sildenafil Citrate; Sulfones; Treatment Outcome; Vasodilator Agents; Ventricular Dysfunction, Right