Unloading the right to fill the left: vasodilation to treat hypotension: a case report.

ABSTRACT:

Background

Management of pulmonary hypertension (PH) in the setting of heart failure with preserved ejection fraction (HFpEF) can be challenging. Herein, we describe the case of a patient with HFpEF and combined pre- and post-capillary PH who showed striking improvement with sildenafil.

Case summary

A 74-year-old man presented with exertional dyspnea and near-syncope. He underwent a hemodynamic exercise study that showed evidence of HFpEF with pre- and post-capillary PH. Right ventricular endomyocardial biopsy showed interstitial fibrosis and mild hypertrophy, with no evidence of infiltrative or storage diseases. The patient was treated with sildenafil 20 mg three times daily, which resulted in significant symptomatic and functional improvement in 12 years of follow-up.

D

SUBMITTER: Ezzeddine FM 

PROVIDER: S-EPMC9161718 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature