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Srpski arhiv za celokupno lekarstvo
2011, vol. 139, iss. 5-6, pp. 376-379
article language: Serbian
document type: Case Report
published on: 16/08/2011
doi: 10.2298/SARH1106376S
The importance of echocardiography in diagnostics of idiopathic pulmonary arterial hypertension: A case report
aOpšta bolnica, Leskovac
bUniveristy of Niš, Faculty of Medicine, Institute of Prevention, Treatment and Rehabilitation of Rheumatic and Cardiovascular Disease 'Niška Banja'
cClinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade



Introduction. Idiopathic pulmonary arterial hypertension (IPAH) is rare and difficult progressive disease with prevalence of approximately 15 cases per million residents, with predominant female cases. Case Outline. A 47-year-old female presented with symptoms and signs of the right heart chambers failure. Over prior seven years the patient had the feeling of suffocation and fatigue when walking, and received treatment for bronchial asthma. Physical examination revealed a marked loud second heart sound over the pulmonary artery. Electrocardiogram: right ventricular hypertrophy. Spirometric (pulmonary capacity) test, cardiac perfusion scan and spiral CT scanning excluded secondary pulmonary arterial hypertension. Blood testing for connective tissue diseases and HIV were within normal reference limits. Transthoracic colour Doppler echocardiography demonstrated a mild tricuspid regurgitation with high values of estimated maximal and middle systolic pressure of the right ventricle (135/110 mm Hg), and excluded previous heart disease. Cardiac catheterization confirmed IPAH diagnosis, with systolic right ventricular pressure of 101/47/66 mm Hg and pulmonary capillary pressure of 30/13/10 mm Hg. Basic therapy with sildenafil, nevertheless, considerable limitations of strain tolerance was still present. Conclusion. IPAH is a severe heart disease with non-specific signs and symptoms. Screening for IPAH is transthoracic colour Doppler echocardiography shows high correlation with cardiac catheterization.


idiopathic pulmonary hypertension; aetiology; diagnosis; therapy


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