Lessons to be learned: a case study approach a case study of the temporal onset of pulmonary hypertension with pre-existent cirrhotic portal hypertension.
We report the occurrence of pulmonary hypertension in a 37-year-old male patient with cirrhosis of the liver, portal hypertension and oesophageal varices. Although this is a rare combination, previous reports have shown that the association of portal and pulmonary hypertension is not coincidental; the temporal onset of primary pulmonary hypertension is hard to predict and our patient was asymptomatic for a number of years. The pathogenesis of portal hypertension leading to pulmonary hypertension is not known. Diagnosis is difficult because the clinico-pathological symptoms in both conditions are similar. Treatment is limited to calcium channel blockers, vasodilators, nitrous oxide and prostacyclin, although most patients will eventually require visceral transplantation.
D'Souza
R
R
Medical Unit, Highland Acute Hospitals NHS Trust, Inverness IV2 3UJ, Scotland. raymonddsou@yahoo.com
MacFadyen
R J
RJ
Kerr
F
F
Peacock
A
A
Steven
M M
MM
D000328:Adult; D004452:Echocardiography; D004562:Electrocardiography; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008297:Male