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Báo cáo y học: "terim prostacyclin therapy for an isolated disconnected pulmonary artery: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: nterim prostacyclin therapy for an isolated disconnected pulmonary artery: a case report. | Grech and Grixti Journal of Medical Case Reports 2010 4 168 http www.jmedicalcasereports.eom content 4 1 168 jA JOURNALOF.MEDICAL CASE REPORTS CASE REPORT Open Access Interim prostacyclin therapy for an isolated disconnected pulmonary artery a case report Victor Grech and Cynthia Grixti Abstract Introduction Disconnected pulmonary arteries are unusual and may result in pulmonary hypertension with acute right heart failure. Case presentation We report a case of a three-month-old Asian girl who presented with heart failure and severe pulmonary hypertension due to a disconnected right pulmonary artery. An epoprostenol prostacyclin infusion was instrumental in lowering pulmonary artery pressures and stabilizing the child prior to surgery. Conclusions This is to the best of our knowledge the first report of successful prostacyclin usage in such a situation. Introduction Disconnected pulmonary arteries are unusual and are almost invariably associated with conotruncal abnormalities 1 . We report a three-month-old infant who presented in heart failure and severe pulmonary hypertension due to a disconnected right pulmonary artery in the absence of conotruncal anomalies. An epo-prostenol prostacyclin infusion was instrumental in lowering pulmonary artery pressures and stabilizing the child prior to surgery. Case presentation Our patient was a three-month-old Asian girl of English nationality born through normal vaginal delivery at full term to healthy and unrelated parents after an uneventful pregnancy. Her birth weight was 3.14 kg. She presented with tachypnoea poor feeding and a cough. Examination showed irritability of the child with respiratory distress subcostal retraction and saturations of 80 to 85 which improved marginally with nasal prong oxygen. She had 4 cm hepatomegaly and auscultation showed a 2 6 early and midsystolic murmur at the lower left sternal edge with a rather loud and single second sound. A chest X-ray showed cardiomegaly with bilateral pulmonary .