Sustained improvement with iloprost in a COPD patient with severe pulmonary hypertension.
Pulmonary hypertension is an important complication of COPD. A small subset of patients with COPD have severe pulmonary hypertension (PH) that is out of proportion to the mild increase in pulmonary arterial pressure observed commonly. Severe PH associated with COPD is associated with increased morbidity and mortality. Treatment options in this group of patients are limited with no conclusive evidence of benefit when drugs approved for treatment of pulmonary arterial hypertension are used. We describe a patient with severe PH associated with COPD who improved clinically and hemodynamically when treated with inhaled iloprost. The improvement was sustained for 2 years. Severe PH in patients with COPD needs to be recognized and novel treatment approaches considered.
Hegewald
Matthew J
MJ
Division of Pulmonary and Critical Care Medicine Intermountain Medical Center, University of Utah School of Medicine, Salt Lake City, UT. Electronic address: matt.hegewald@imail.org.
Elliott
C Gregory
CG
Division of Pulmonary and Critical Care Medicine Intermountain Medical Center, University of Utah School of Medicine, Salt Lake City, UT.
D000280:Administration, Inhalation; D000368:Aged; D001784:Blood Gas Analysis; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D016285:Iloprost / Q000008:administration & dosage*; D008297:Male; D020714:Maximum Tolerated Dose; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D016285:Iloprost