Article metrics

  • citations in SCindeks: 0
  • citations in CrossRef:0
  • citations in Google Scholar:[=>]
  • visits in previous 30 days:1
  • full-text downloads in 30 days:1
article: 1 from 1  
Back back to result list
Srce i krvni sudovi
2016, vol. 35, iss. 2, pp. 60-64
article language: English
document type: Case Report
published on: 13/07/2018
doi: 10.5937/siks1602060N
The benefit of using a low dose calcium channel blocker in a patient with idiopathic pulmonary hypertension
aUniversity of Belgrade, Faculty of Medicine
bClinical Center of Serbia, Clinic for Cardiology, Belgrade
cInstitute of Public Health Sabac, Sabac
dUniversity of Belgrade, Faculty of Medicine + Clinical Center of Serbia, Clinic for Cardiology, Belgrade



Introduction: Pulmonary arterial hypertension is defined by hemodynamic and pathophysiological changes of increased resting mean pulmonary arterial pressure ≥ 25mmHg estimated by right heart catheterisation. Case report: We describe a 44-year-old woman who presented for evaluation 13 years after being diagnosed with primary pulmonary hypertension. Over that extended period of time, she did not develop any changes in her coronary or pulmonary vascular measurements as documented by repeat catheterization. She did not have signs of systemic connective tissue disease. Throughout this time, she was managed with continuous medical treatment of low-doses of a Ca-channel antagonist (nifedipine 10mg twice per day) along with oral anticoagulant therapy. Her ongoing complaints were of fatigue when engaged in heavy physical activity, but there was no progression of symptoms. She also occasionally felt symptoms of increased heart rate and syncope. Auscultation revealed a systolic murmur along the left parasternal edge and an accented second sound of the pulmonary artery. Electrocardiography showed sinus rhythm and incomplete right bundle branch block. Echocardiography was consistent with signs of pulmonary hypertension. Conclusion: A small number of patients with pulmonary hypertension have a good prognosis with treatment with modest doses of calcium blockers as seen in our patient who has had a stable course of disease for many years.



*** (2012) What is pulmonary hypertension?. American Heart Association, Jun,
Abe, K., Shimokawa, H., Morikawa, K., Uwatoku, T., Oi, K., Matsumoto, Y., Hattori, T., Nakashima, Y., Kaibuchi, K., Sueishi, K., Takeshit, A. (2004) Long-Term Treatment With a Rho-Kinase Inhibitor Improves Monocrotaline-Induced Fatal Pulmonary Hypertension in Rats. Circulation Research, 94(3): 385-393
Badesch, D.B., Raskob, G.E., Elliott, C.G., i dr. (2010) Pulmonary hypertension: Baseline characteristics from the REVEAL Registry. Chest, 137, 376-387
Chin, K.M., Rubin, L.J. (2008) Pulmonary Arterial Hypertension. Journal of the American College of Cardiology, 51(16): 1527-1538
Galiè, N., Hoeper, M.M., Humbert, M., Torbicki, A., Vachiery, J.L., Barberaet, J.A., i dr. (2009) Guidelines for the diagnosis and treatment of pulmonary hypertension: The task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS),. Eur Heart J., 30(20), str. 2493-537
Galiè, N., Manes, A., Negro, L., Palazzini, M., Bacchi-Reggiani, M.L., Branzi, A. (2009) A meta-analysis of randomized controlled trials in pulmonary arterial hypertension. Eur Heart J., 30(4), str. 394-403
Guignabert, C., Izikki, M., Tu, L.I., Li, Z., Zadigue, P., Barlier-Mur, A., Hanoun, N., Rodman, D., Hamon, M., Adnot, S., Eddahibi, S. (2006) Transgenic Mice Overexpressing the 5-Hydroxytryptamine Transporter Gene in Smooth Muscle Develop Pulmonary Hypertension. Circulation Research, 98(10): 1323-1330
Humbert, M., Sitbon, O., Chaouat, A., Bertocchi, M., Habib, G., Gressin, V., Yaici, A., Weitzenblum, E., Cordier, J., Chabot, F., Dromer, C., Pison, C., Reynaud-Gaubert, M., Haloun, A. (2006) Pulmonary Arterial Hypertension in France. American Journal of Respiratory and Critical Care Medicine, 173(9): 1023-1030
Lapa, M., Dias, B., Jardim, C., Fernandes, C.J.C., Dourado, P.M.M., Figueiredo, M., Farias, A., Tsutsui, J., Terra-Filho, M., Humbert, M., Souza, R. (2009) Cardiopulmonary Manifestations of Hepatosplenic Schistosomiasis. Circulation, 119(11): 1518-1523
McLaughlin, V.V., Shillington, A. (2002) Survival in Primary Pulmonary Hypertension: The Impact of Epoprostenol Therapy. Circulation, 106(12): 1477-1482
McLaughlin, V.V., Archer, S.L., Badesch, D.B., Barst, R.J., Farber, H.W., Lindner, J.R., Mathier, M.A., McGoon, M.D., Park, M.H., Rosenson, R.S., Rubin, L.J., Tapson, V.F., Varga, J. (2009) ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension. Circulation, 119(16): 2250-2294
Mukerjee, D. (2003) Prevalence and outcome in systemic sclerosis associated pulmonary arterial hypertension: application of a registry approach. Annals of the Rheumatic Diseases, 62(11): 1088-1093
Oudiz, R. (2007) Pulmonary hypertension. Primary, eMedicine, August, Available at URL:
Peacock, A. (2003) Treatment of pulmonary hypertension. BMJ, 326(7394): 835-836
Petkov, V., Mosgoeller, W., Ziesche, R., Raderer, M., Stiebellehner, L., Vonbank, K., Funk, G., Hamilton, G., Novotny, C., Burian, B., Block, L. (2003) Vasoactive intestinal peptide as a new drug for treatment of primary pulmonary hypertension. Journal of Clinical Investigation, 111(9): 1339-1346
Porhownik, N.R., Bshouty, Z. (2007) Pulmonary arterial hypertension: A serious problem. Perspect Cardiol, 23: 33-40
Rich, S., Dantzker, D.R., Ayres, S.M., Bergofsky, E.H., Brundage, B.H., Detre, K.M., Fishman, A.P., Goldring, R.M., Groves, B.M., Koerner, S.K. (1987) Primary pulmonary hypertension. A national prospective study. Ann Intern Med, 107(2): 216-23
Rich, S., Kaufmann, E., Levy, P.S. (1992) The Effect of High Doses of Calcium-Channel Blockers on Survival in Primary Pulmonary Hypertension. New England Journal of Medicine, 327(2): 76-81
Rubin, L.J., Badesch, D.B. (2005) Evaluation and management of the patient with pulmonary arterial hypertension. Ann Intern Med, 143, str. 282-92
Rudarakanchana, N., Trembath, R.C., Morrell, N.W. (2001) New insights into the pathogenesis and treatment of primary pulmonary hypertension. Thorax, 56, str. 888-90
Runo, J.R., Loyd, J.E. (2003) Primary pulmonary hypertension. Lancet, 361(9368): 1533-1544
Schermuly, R.T. (2005) Reversal of experimental pulmonary hypertension by PDGF inhibition. Journal of Clinical Investigation, 115(10): 2811-2821
Simonneau, G., Robbins, I.M., Beghetti, M., Channick, R.N., Delcroix, M., Denton, C.P., Elliott, C., Gaine, S.P., Gladwin, M.T., Jing, Z., Krowka, M.J., Langleben, D., Nakanishi, N., Souza, R. (2009) Updated clinical classification of pulmonary hypertension. Journal of the American College of Cardiology, 54(1 Suppl): S43-54
Sitbon, O., Humbert, M., Jäis, X. (2005) Long-Term Response to Calcium Channel Blockers in Idiopathic Pulmonary Arterial Hypertension. ACC Current Journal Review, 14(10): 30
Thenappan, T., Shah, S.J., Rich, S., Gomberg-Maitland, M. (2007) A USA-based registry for pulmonary arterial hypertension: 1982 2006. European Respiratory Journal, 30(6): 1103-1110
Yigla, M., Kramer, M.R., Bendayan, D., i dr. (2004) Unexplained severe pulmonary hypertension in the elderly: report on 14 patients. Isr Med Assoc J, 6: 78-81