Nitric oxide inhalation is useful in the management of right ventricular failure caused by myocardial infarction.
OBJECTIVE
To describe hemodynamic improvement in a patient treated with nitric oxide (NO) inhalation in the management of right ventricular failure caused by myocardial infarction.


METHODS
Case report.


METHODS
An intensive care unit of a university hospital.


METHODS
A 66-yr-old man with severe right ventricular failure caused by acute myocardial infarction.


METHODS
Nitric oxide inhalation through a ventilator circuit.


RESULTS
The patient complained of chest pain. When myocardial infarction was diagnosed, he underwent percutaneous transluminal coronary angioplasty and percutaneous transluminal coronary recanalization, but they were not effective. We instituted intra-aortic balloon pumping and brought the patient to the intensive care unit (ICU). Even with high-dose inotropic support, his hemodynamics deteriorated gradually. On the patient's seventh day in the ICU, we started NO inhalation at 5-10 ppm in an attempt to relieve his right heart failure. Immediately after NO inhalation was started, his hemodynamics improved significantly, and we could wean the patient from intra-aortic balloon pumping. NO inhalation was continued for 9 days and was successfully discontinued without circulatory deterioration. He was discharged from our hospital uneventfully.


CONCLUSIONS
Nitric oxide inhalation improved hemodynamics in our patient with right ventricular failure after myocardial infarction. Our report suggests that a clinical trial of NO treatment for severe right ventricular failure caused by myocardial infarction is warranted.
Fujita
Yoshihito
Y
Department of Anesthesiology and Resuscitology, Nagoya City University Medical School, Nagoya, Japan. yfujita@med.nagoya-u.ac.jp
Nishida
Osamu
O
Sobue
Kazuya
K
Ito
Hiroaki
H
Kusama
Nobuyoshi
N
Inagaki
Masaaki
M
Katsuya
Hirotada
H
D000280:Administration, Inhalation; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018497:Ventricular Dysfunction, Right / Q000188:drug therapy* / Q000209:etiology
D014665:Vasodilator Agents; D009569:Nitric Oxide