Abstract
We report the case of a treatment-naive patient with pulmonary arterial hypertension who presented with decompensated right ventricular failure and cardiogenic shock. Unstable hemodynamics, hypoxia and end-organ hypoperfusion limited up-titration of pharmacotherapy. Mechanical circulatory support with veno-venous extracorporeal membrane oxygenation (VV-ECMO) was initiated to permit dose titration of pulmonary vasodilator therapy. VV-ECMO was weaned after 10 days of support, with successful transition to intravenous epoprostenol and oral sildenafil.
MeSH terms
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Administration, Oral
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Adult
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Antihypertensive Agents / administration & dosage
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Antihypertensive Agents / therapeutic use
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Combined Modality Therapy
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Epoprostenol / administration & dosage
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Epoprostenol / therapeutic use*
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Extracorporeal Membrane Oxygenation / methods*
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Female
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Humans
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Hypertension, Pulmonary / therapy*
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Injections, Intravenous
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Piperazines / administration & dosage
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Piperazines / therapeutic use*
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Purines / administration & dosage
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Purines / therapeutic use
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Shock, Cardiogenic / therapy
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Sildenafil Citrate
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Sulfones / administration & dosage
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Sulfones / therapeutic use*
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Treatment Outcome
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Vasodilator Agents / administration & dosage
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Vasodilator Agents / therapeutic use
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Ventricular Dysfunction, Right / therapy
Substances
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Antihypertensive Agents
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Piperazines
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Purines
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Sulfones
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Vasodilator Agents
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Sildenafil Citrate
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Epoprostenol