Téma:  Case Studies

Initial combination therapy in patient with pulmonary arterial hypertension – description of the case and analysis approach

Ivan Varga, Milan Luknár, Peter Solík, Peter Lesný, Eva Goncalvesová

Pulmonary arterial hypertension (PAH) associated with connective tissue diseases (CTD) represents the most frequent entity in the subgroup of associated PAH (APAH). Here we present an analysis approach and case report of a woman with 5 years history of CTD. She was admitted to hospital for right heart failure and pulmonary hypertension. One day after admission was the hospitalization complicated by soporous state and circulatory colapse caused by right ventricular failure due to pulmonary hypertension and superimposed cerebral vasculitis was suspected. Therapy was started immediately with puls of methylprednisolone and cyclophosphamide. Right heart catheterization revealed advanced PAH with severe right ventricle dysfunction. We decided to start specific PAH treatment with combination of sildenafil and bosentan. Clinical and hemodynamic stabilisation was achieved in a few days and sustained also after 8 months. Initial combination therapy could be an suitable method for patients with advanced PAH especially in instable cases with necessity of immediate action and unknown patient preference.

Ročník 2010  Témy časopisu Internal medicine 10 / 2010

CHAIRMAN OF THE EDITORIAL BOARD
prof. MUDr. Ivica Lazúrová, CSc. FRCP

REPRESENTATIVE OF CHAIRMAN
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MEMBERS OF THE EDITORIAL BOARD
doc. MUDr. Viera Fábryová, CSc.
MUDr. Viera Fedelešová, CSc.
prof. MUDr Martin Haluzík, CSc.
prof. MUDr. Štefan Hrušovský, CSc. Dr.SVS.
prof. MUDr. Rudolf Hyrdel, CSc.
doc. MUDr. Oľga Jurkovičová, CSc.
doc. MUDr. Zdenko Killinger, PhD.
doc. MUDr. Soňa Kiňová, PhD.
prof. MUDr. Peter Mitro, PhD.
doc. MUDr. Viliam Mojto, CSc., MHA
prof. MUDr. Karel Pacák, DrSc.
prof. MUDr. Juraj Payer, CSc., FRCP
doc. MUDr. Ján Podoba, CSc.
prof. MUDr. Igor Riečanský, DrSc.
doc. MUDr. Ján Staško, PhD.
doc. MUDr. Mária Szántová, PhD.
prof. MUDr. Ivan Tkáč, PhD.

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3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
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