[Early polysomnographic detection of congestive heart failure caused by aortic valve stenosis].
BACKGROUND
Obstructive sleep apnea (OSAS) is assumed to be an independent cardiovascular risk factor, whereas central sleep apnea with Cheyne-Stokes breathing occurs in congestive heart failure and has a prognostic value.


METHODS
The case of a 74-year-old man with long-term continuous positive airway pressure treatment due to OSAS is reported. In a routine polysomnography central apneas and Cheyne-Stokes breathing without any clinical signs of heart failure were seen. Further investigations revealed a newly diagnosed aortic valve stenosis with good left ventricular function. Clinical signs of congestive heart failure came up 2 weeks after first diagnosed Cheyne-Stokes breathing.


CONCLUSIONS
Cheyne-Stokes breathing can be observed in acute heart failure before occurrence of any clinical signs of congestive heart failure and should always lead to further investigations. The current understanding of pathophysiological pathways in Cheyne-Stokes breathing is reviewed.
Walther
Jörg Werner
JW
Berufsgenossenschaftliche Kliniken Bergmannsheil, Medizinische Klinik III, Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Klinikum der Ruhr-Universität Bochum. Joerg.walther@ruhr-uni-bochum.de
Duchna
Hans Werner
HW
Schlosser
Barbara Monika
BM
de Zeeuw
Justus
J
Schultze-Werninghaus
Gerhard
G
Orth
Maritta
M
D000368:Aged; D001024:Aortic Valve Stenosis / Q000175:diagnosis*; D002639:Cheyne-Stokes Respiration / Q000175:diagnosis*; D045422:Continuous Positive Airway Pressure; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D017286:Polysomnography; D011379:Prognosis; D020182:Sleep Apnea, Central / Q000175:diagnosis*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy