Continuous positive airway pressure treatment in addition to optimal medical therapy for ventricular ectopy in a patient with heart failure and sleep-related breathing disorder.
In this report we describe the case of a 56-year-old man with a medical history of onset of asthenia, palpitations and dyspnoea for mild efforts. After a negative ergometric test for myocardial ischaemia and 24-h Holter monitoring showing frequent ventricular premature beats, but an echocardiogram with significant dilation and dysfunction of the left ventricle, coronary angiography was performed and did not show haemodynamically significant stenosis. Regarding the anamnesis of snoring, daytime sleepiness and the relationship between sleep-related breathing disorder and cardiovascular disease, we performed a cardiorespiratory sleep study that indicated a diagnosis of sleep-related breathing disorder with prevalent obstructive apnoea. In addition to optimal medical therapy for cardiovascular disease, the patient began therapy with continuous positive airway pressure during the night. This showed a considerable decrease in ventricular premature beats (VPBs) during the night, a better control of ventricular ectopy during the day and a better compliance with medical therapy.
Vitulano
Nicola
N
Department of Cardiology, Catholic University of Rome, Italy. nickvit@libero.it
Giubilato
Giovanna
G
Santangeli
Pasquale
P
Ierardi
Carolina
C
Pieroni
Maurizio
M
Bellocci
Fulvio
F
Crea
Filippo
F
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use; D000077261:Carvedilol; D045422:Continuous Positive Airway Pressure; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000627:therapeutic use; D011859:Radiography; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D017180:Tachycardia, Ventricular / Q000628:therapy; D013777:Tetrazoles / Q000627:therapeutic use; D014463:Ultrasonography; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000068756:Valsartan; D018879:Ventricular Premature Complexes / Q000628:therapy*
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D002227:Carbazoles; D011412:Propanolamines; D013777:Tetrazoles; D000077261:Carvedilol; D000068756:Valsartan; D014633:Valine