title: Exercise-induced pulmonary artery hypertension in a patient with compensated cardiac disease: hemodynamic and functional response to sildenafil therapy.
abstract: We describe the case of a 54-year-old man who presented with exertional dyspnea and fatigue that had worsened over the preceding 2 years, despite a normally functioning bioprosthetic aortic valve and stable, mild left ventricular dysfunction (left ventricular ejection fraction, 0.45). His symptoms could not be explained by physical examination, an extensive biochemical profile, or multiple cardiac and pulmonary investigations. However, abnormal cardiopulmonary exercise test results and a right heart catheterization-combined with the use of a symptom-limited, bedside bicycle ergometer-revealed that the patient's exercise-induced pulmonary artery hypertension was out of proportion to his compensated left heart disease. A trial of sildenafil therapy resulted in objective improvements in hemodynamic values and functional class.
authors: Lazaros
authors: L
authors: Nikolaidis
authors: Nabeel
authors: N
authors: Memon
authors: Brian
authors: B
authors: O'Murchu
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006328:Cardiac Catheterization; D015444:Exercise; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000067716:Point-of-Care Testing; D011237:Predictive Value of Tests; D000068677:Sildenafil Citrate / Q000627:therapeutic use*; D013318:Stroke Volume; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D016277:Ventricular Function, Left
chemical_list: D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate
keywords: Exercise hemodynamics; exercise test; exercise tolerance; exercise-induced pulmonary hypertension; hypertension, pulmonary/diagnosis/drug therapy/etiology; phosphodiesterase 5 inhibitors/therapeutic use; pulmonary arterial hypertension; pulmonary vascular resistance; sildenafil