A case of primary pulmonary hypertension:acute and chronic effect of vasodilators Naoki Funayama 1 , Takashi Takenaka 1 , Masashi Horimoto 1 , Takeki Igarashi 1 1The Department of Cardiology, Sapporo National Hospital pp.217-222
Published Date 1987/2/15
DOI https://doi.org/10.11477/mf.1404205014
  • Abstract
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A forty three year old female was admitted for the complaint of exertional dyspnea and cough, which started 3 years before the admission. The patient had no past histories of thromboembolic disease. Electro-cardiogram showed right axis deviation and right ventricular hypertrophy. Chest rentogenogram showed a prominence of proximal pulmonary arteries and diminished vascularity of peripheral pulmonary arte-ries. Right heart catheterization revealed a markedly elevated pulmonary arterial pressure (PAP) in addition to increased total pulmonary resistence (TPR). Pul-monary capillary wedge pressure was within normal range and results of oximetry excluded the possibility of intracardiac shunt. No evidence of pulmonary scintigraphy and pulmonary arteriography was found.

From above findings primary pulmonary hyperten-sion (PPH) was finally diagnosed for the patient. Isosorbide dinitrate, Nifedipine, Prazosin and Captopril were independently administered to the patient in order to evaluate a short term-effect of the vasodilators. As a result, Isosorbide dinitrate and Prazosin were found to be effective of reduction in PAP and TPR, while the remaining drugs were not effective. The combined administration of long acting ISDN (10mg/day) and Prazosin (6mg,day) was, therefore, initiated in order to assess its long-term effect. A marked reduction in PAP from 114 10 (mean 66) mmHg to 70/30 (mean 431 mmHg and in TPR from 1.191 to 841 dyn・sec・ cm-5 were found one month after the drug admini-stration. Moreover, we recognized persistent reduction in PAP and TPR one year after the administration. It was concluded that the combined administration of long acting ISDN and Prazosin could be fairly effec-tive as a long-term treatment of PPH.

Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.


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