Cases reported "Hypertension, Pulmonary"

Filter by keywords:



Filtering documents. Please wait...

1/67. Anaesthesia for caesarean section in the presence of severe primary pulmonary hypertension.

    We describe the case of a pregnant woman, 35 weeks' gestation, with primary pulmonary hypertension and coarctation of the aorta requiring emergency Caesarean section under general anaesthesia. The patient had a pulmonary artery catheter inserted before operation which revealed pulmonary artery pressures in excess of 80/40 mm Hg. These were lowered using an infusion of glyceryl trinitrate. After delivery of the baby and administration of oxytocin, pulmonary artery pressures were more difficult to control. An infusion of prostacyclin was substituted which stabilized pulmonary pressures. After operation, she was transferred to the intensive care unit where prostacyclin was administered by an "aerosolized" route. Her trachea was extubated after 48 h and she made an uneventful recovery.
- - - - - - - - - -
ranking = 1
keywords = gestation
(Clic here for more details about this article)

2/67. Inhaled nitric oxide therapy in pregnancy complicated by pulmonary hypertension.

    The use of nitric oxide as an agent to reduce pulmonary artery pressure in a pregnancy complicated by pulmonary hypertension is reported for the first time. This therapy can reduce pulmonary vascular resistance and therefore potentially enable the right ventricle to better compensate for the physiologic changes of pregnancy.
- - - - - - - - - -
ranking = 15.272383368019
keywords = pregnancy
(Clic here for more details about this article)

3/67. Primary pulmonary hypertension with fatal outcome in a young woman and review of the literature.

    A 32-year-old female is described, who was admitted with symptoms of severe right heart failure. The most likely diagnosis of pulmonary embolism was excluded. echocardiography and left-right catheterisation confirmed the diagnosis of primary pulmonary hypertension. A possible mediator in the process of PPH could be the appetite suppressants she had taken for some months after her second pregnancy. Before further pharmacologic tests could be performed the patient died in circulatory collapse. Postmortem pathological examination confirmed the diagnosis of PPH by the presence of narrowed pulmonary arterioles, media hypertrophy, thrombotic lesions and normal surrounding pulmonary parenchyma. The literature on primary pulmonary hypertension is revised with special emphasis on diagnosis and treatment algorithms.
- - - - - - - - - -
ranking = 2.5453972280032
keywords = pregnancy
(Clic here for more details about this article)

4/67. cesarean section in a mother with uncorrected congenital coronary to pulmonary artery fistula.

    PURPOSE: We report a case of a 33 yr old woman with pulmonary hypertension secondary to uncorrected right coronary artery to pulmonary artery fistula who underwent two successful operative deliveries under general anesthesia. CLINICAL FEATURES: This woman underwent an emergency Caesarean section at 32 wk gestation because she presented in NYHA Class IV, heart failure and premature labour. She did not have antenatal follow-up. For her second pregnancy, she was managed from the first trimester of pregnancy by the cardiologist, obstetrician and anesthesiologist. She received oral furosemide and digoxin from eight weeks gestation. Pregnancy was managed to term before she progressed to NYHA Class IV and cardiac failure at 37 wk gestation. She had a Caesarean section under general anesthesia. She received rapid sequence induction of anesthesia and tracheal intubation with 0.1 mg x kg(-1) etomidate, 2 mg x kg(-1) succinylcholine and maintenance with nitrous oxide 50% in oxygen, isoflurane 1% and 0.1 mg x kg(-1) vecuronium. fentanyl, 2 microg x kg(-1) helped to obtund the hypertensive response to intubation. analgesia was provided with 1 mg x kg(-1) morphine. Glyceryl trinitrate infusion, 10-30 microg x min(-1) was used in addition to the anti-heart failure therapy. End-tidal capnography, electrocardiogram, pulse oximetry, continuous arterial blood pressure and pulmonary arterial catheter provided hemodynamic monitoring. The lungs were mechanically ventilated for 24 hr postoperatively. She received anti-heart failure therapy which she continued after discharge. She was NYHA class II upon discharge. She defaulted from further follow-up. CONCLUSION: Although the literature advocates, in this situation, controlled vaginal delivery utilising epidural analgesia, we describe the successful outcome for operative delivery under general anesthesia in a patient with secondary pulmonary hypertension and heart failure.
- - - - - - - - - -
ranking = 8.0907944560065
keywords = pregnancy, gestation
(Clic here for more details about this article)

5/67. Diagnosing and treating primary pulmonary hypertension.

    Primary pulmonary hypertension (PPH) is a pulmonary vascular disease characterized by an elevation in mean pulmonary artery pressure and pulmonary vascular resistance. Recently, PPH gained national attention because of its association with appetite suppressants. PPH may also be associated with pregnancy, hypothyroidism, autoimmune disorders, human immunodeficiency virus infection, and the use of drugs such as oral contraceptives and cocaine. patients with PPH may report dyspnea on exertion and fatigue. early diagnosis is crucial. New therapeutic regimens have dramatically reduced mortality rates and improved quality of life by halting the progression of pulmonary vascular remodeling and averting right-sided heart failure. These therapies include high-dose calcium channel antagonists, anticoagulants, and continuous intravenous prostacyclin. Lung or heart-lung transplantation remains a viable therapeutic option for patients who are treated late in the disease process, who are not responsive to medical management, or who remain symptomatic and continue to deteriorate.
- - - - - - - - - -
ranking = 2.5453972280032
keywords = pregnancy
(Clic here for more details about this article)

6/67. Twin pregnancy in a woman on long-term epoprostenol therapy for primary pulmonary hypertension. A case report.

    BACKGROUND: Pregnancy associated with primary pulmonary hypertension is an uncommon observation, with maternal mortality > 50%. Experience treating this condition is limited. Past reports have emphasized the need for pregnancy termination. In the last few years there has been considerable interest in long-term intravenous use of epoprostenol (prostacyclin) in patients with primary pulmonary hypertension. CASE: A woman with severe primary pulmonary hypertension who was on long-term epoprostenol therapy became pregnant with twins and was treated with high doses of epoprostenol and nitric oxide during delivery and the postpartum period. She was well six months later on continuous epoprostenol therapy. The one viable infant was alive and still hospitalized at this writing. CONCLUSION: epoprostenol therapy may be continued during pregnancy in patients with severe primary pulmonary hypertension for long-term pulmonary vasodilatation.
- - - - - - - - - -
ranking = 15.272383368019
keywords = pregnancy
(Clic here for more details about this article)

7/67. Persistent pulmonary hypertension after maternal naproxen ingestion in a term newborn: a case report.

    Constricting effect of indomethacin on the ductus arteriosus of the fetus is well known. The fetal effects of other nonsteroid anti-inflammatory drugs (NSAIDs) like naproxen are not well reported. We report here a case of a 3,790-g term neonate who developed persistent pulmonary hypertension after birth with a closed ductus arteriosus. The mother admitted to taking naproxen sodium immediately prior to the birth of the infant. The course of illness was progressively better on conservative management. Like indomethacin, other NSAIDs can also cause premature closure of fetal ductus arteriosus, pulmonary hypertension, and life-threatening problems to the neonate. Patient education regarding over-the-counter pain medication during pregnancy should be emphasized.
- - - - - - - - - -
ranking = 2.5453972280032
keywords = pregnancy
(Clic here for more details about this article)

8/67. Successful pregnancy outcome with cardiac and severe restrictive lung disease requiring mechanical ventilation: a case report and literature review.

    The prognosis for pulmonary hypertension as a single entity is poor, but when it is superimposed on the physiological changes of pregnancy, it produces a lethal condition, with maternal mortality rates greater than 50%. We present a successfully managed case followed by a review and discussion of the available literature on this subject. A 24-year-old woman, a primigravida, was mechanically ventilated for severe restrictive lung disease. Her pregnancy required close surveillance of her labile cardiopulmonary status as well as fetal well-being. Her delivery was scheduled for induction at 34 weeks' gestation, but she required an emergency cesarean section, which was productive of a healthy infant. Her recovery was complicated by recurrent fever. There is limited literature on restrictive lung disease and pulmonary hypertension with regards to their management during pregnancy. Nevertheless, successful pregnancy outcomes may result with careful multidisciplinary management.
- - - - - - - - - -
ranking = 21.363177824026
keywords = pregnancy, gestation
(Clic here for more details about this article)

9/67. Use of inhaled nitric oxide for emergency cesarean section in a woman with unexpected primary pulmonary hypertension.

    PURPOSE: Use of inhaled nitric oxide (iNO) could be of importance in emergency cases of primary pulmonary hypertension (PPH) in pregnant patients during labour and delivery. iNO acts as a selective pulmonary bed vasodilator avoiding systemic hemodynamic effects due to its ease of administration. Pulmonary bed vasodilation improves right ventricular function directly and left ventricular function indirectly. CLINICAL FEATURES: We report the case of a pregnant patient with unexpected PPH in whom an emergency cesarean section (CS) had to be performed. PPH was diagnosed on admission as she arrived in active labour at 34 weeks gestational age. An emergency CS was performed under epidural anesthesia for breech presentation . All along labour, delivery and the first 24 hr, iNO was administered via a noninvasive ventilation device. CS was uneventful. A severe pulmonary hypertensive crisis was observed 12 hr after delivery and resolved with an increase of iNO concentration and administration of isoprenalin. The patient and baby returned home on day ten. CONCLUSION: The ease of administration of iNO allowed the optimal control of pulmonary arterial hypertension. No interaction with epidural anesthesia was observed. Use of iNO can improve the management of urgent CS in women with unexpected PPH.
- - - - - - - - - -
ranking = 1
keywords = gestation
(Clic here for more details about this article)

10/67. Primary pulmonary hypertension in pregnancy; a role for novel vasodilators.

    We describe the case of a 28-week pregnant woman presenting with severe primary pulmonary hypertension (PPH). She had an elective Caesarean section under general anaesthesia at 32 weeks gestation. pulmonary artery pressures (PAP) measured from a pulmonary artery catheter before anaesthesia were in excess of 100 mm Hg. Intraoperative nitric oxide was used to reduce PAP. After the delivery of a healthy infant PAP was controlled with nebulized iloprost and a prostacyclin infusion. Seven days later she was discharged from intensive care taking an oral calcium antagonist and warfarin. She developed intractable right heart failure and died 14 days after delivery. Despite increasing experience in the use of drugs to reduce PAP, the clinical course of pregnancy complicated by severe PPH is usually fatal.
- - - - - - - - - -
ranking = 13.726986140016
keywords = pregnancy, gestation
(Clic here for more details about this article)
| Next ->


Leave a message about 'Hypertension, Pulmonary'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.