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open access

Vol 75, No 1 (2007)
Case report
Submitted: 2013-02-22
Published online: 2007-04-13
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Unusual cause of right heart failure decompensation in 21-years old patient with idiopathic pulmonary arterial hypertension - a case report

Michał Florczyk, Anna Stawecka-Pawełczyk, Marcin Kurzyna, Anna Fijałkowska, Janusz Burakowska, Joanna Żyłkowska, Monika Szturmowicz, Liliana Wawrzyńska, Witold Tomkowski, Adam Torbicki
Pneumonol Alergol Pol 2007;75(1):95-99.

open access

Vol 75, No 1 (2007)
CASE REPORTS
Submitted: 2013-02-22
Published online: 2007-04-13

Abstract

The authors describe a case of 21-years old woman with idiopathic pulmonary arterial hypertension with atypical clinical consequences of massive internal bleeding. Despite significant hypovolemia clinical and laboratory presentation was one of RV failure with dilatation of right heart ventricle and increased plasma level of markers of myocardial stretch and injury (NT-proBNP and troponin, respectively). This is attributed to impaired right ventricular coronary perfusion and hypoxia. Intensive treatment restored baseline RV conditions and at 15 months follow-up no persistent right heart impairment was observed. This case demonstrates that bleeding should be also considered in differential diagnosis of exacerbation of right ventricular failure in patients with pulmonary arterial hypertension.

Abstract

The authors describe a case of 21-years old woman with idiopathic pulmonary arterial hypertension with atypical clinical consequences of massive internal bleeding. Despite significant hypovolemia clinical and laboratory presentation was one of RV failure with dilatation of right heart ventricle and increased plasma level of markers of myocardial stretch and injury (NT-proBNP and troponin, respectively). This is attributed to impaired right ventricular coronary perfusion and hypoxia. Intensive treatment restored baseline RV conditions and at 15 months follow-up no persistent right heart impairment was observed. This case demonstrates that bleeding should be also considered in differential diagnosis of exacerbation of right ventricular failure in patients with pulmonary arterial hypertension.

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Keywords

idiopathic pulmonary arterial hypertension; right heart failure decompensation; troponin

About this article
Title

Unusual cause of right heart failure decompensation in 21-years old patient with idiopathic pulmonary arterial hypertension - a case report

Journal

Advances in Respiratory Medicine

Issue

Vol 75, No 1 (2007)

Article type

Case report

Pages

95-99

Published online

2007-04-13

Bibliographic record

Pneumonol Alergol Pol 2007;75(1):95-99.

Keywords

idiopathic pulmonary arterial hypertension
right heart failure decompensation
troponin

Authors

Michał Florczyk
Anna Stawecka-Pawełczyk
Marcin Kurzyna
Anna Fijałkowska
Janusz Burakowska
Joanna Żyłkowska
Monika Szturmowicz
Liliana Wawrzyńska
Witold Tomkowski
Adam Torbicki

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