Browse > Article

A Case of Primary Pulmonary Hypertension in Pregnancy Presented as Massive Hemoptysis  

Kim, Myung Sook (Department of Internal Medicine, Daejon St. Mary's Hospital, The Catholic University of Korea)
Kim, Hyoung Doo (Department of Internal Medicine, Daejon St. Mary's Hospital, The Catholic University of Korea)
Kim, Seok Chan (Department of Internal Medicine, Daejon St. Mary's Hospital, The Catholic University of Korea)
Kwan, Soon Suk (Department of Internal Medicine, Daejon St. Mary's Hospital, The Catholic University of Korea)
Kim, Young Kyoon (Department of Internal Medicine, Daejon St. Mary's Hospital, The Catholic University of Korea)
Kim, Kwan Hyoung (Department of Internal Medicine, Daejon St. Mary's Hospital, The Catholic University of Korea)
Moon, Hwa Sik (Department of Internal Medicine, Daejon St. Mary's Hospital, The Catholic University of Korea)
Song, Jeong Sup (Department of Internal Medicine, Daejon St. Mary's Hospital, The Catholic University of Korea)
Park, Sung Hak (Department of Internal Medicine, Daejon St. Mary's Hospital, The Catholic University of Korea)
Publication Information
Tuberculosis and Respiratory Diseases / v.57, no.1, 2004 , pp. 66-71 More about this Journal
Abstract
Primary pulmonary hypertension (PPH) is a rare, progressive and incurable disease, which is characterized by an increase in the pulmonary artery pressure without a demonstrable cause. The most common presenting symptom is dyspnea on exertion, with other symptoms comprising of chest pain, syncope and hemoptysis. The diagnosis is one of exclusion of any of the known causes of pulmonary hypertension. When associated with pregnancy, the maternal mortality ranges from 30 to 50%. Because pregnancy and labor are very serious problems for patients with PPH, the available evidence suggests that pregnancy when afflicted with PPH should be avoided. In account the case of a 33-year old patient, reporting with massive hemoptysis, and diagnosed with PPH during her twenty seventh week of gestation, is presented. She was treated with conservative management, including oxygen and a vasodilator, and underwent a pregnancy termination. However, due to aggravation of right heart failure, she presented with severe systemic hypotension and hypoxemia, and eventually died. This case is reported, with brief review of the literature.
Keywords
Primary pulmonary hypertension; Pregnancy; Hemoptysis;
Citations & Related Records

Times Cited By SCOPUS : 0
연도 인용수 순위
  • Reference
1 Goodwin TM, Gherman RB, Hameed A, Elkayam U. Favorable response of Eisenmenger syndrome to inhaled nitric oxide during pregnancy. Am J ObstetGynecol 1999;180:64-7
2 Olschewski H, Walmrath D, Schermuly R, Ghofrani A, Grimminger F, Seeger W. Aerosolized prostacyclin and iloprost in severe pulmonary hypertension. AnnIntern Med 1996;124:820-4
3 Mccaffrey RM, Dunn LJ. Primary pulmonary hypertension in pregnancy. Obstet Gynecol Surv 1964;19:567-91
4 Robinson JN, Banerjee R, Landzberg MJ, Thiet MP. Inhaled nitric oxide therapy in pregnancy complicated by pulmonary hypertension. Am J Obstet Gynecol1999;180:1045-6
5 Monnery L, Nanson J, Charlton G. Primary pulmonary hypertension in pregnancy; a role for novel vasodilators. Br J Anaesth 2001;87:295-8
6 Lee SD, Shroyer KR, Markham NE, Cool CD, Voelkel NF, Tuder RM. Monoclonal endothelial cell proliferation is present in primary but not secondary pulmonary hypertension. J Clin Invest 1998;101(5):927-34
7 Lam GK, Stafford RE, Thorp J, Moise KJ Jr, Cairns BA. Inhaled nitric oxide for primary pulmonary hypertension in pregnancy. Obstet Gynecol 2001;98:895-8
8 Weiss BM, Zemp L, Seifert B, Hess OM. Outcome of pulmonary vascular disease in pregnancy: a systematic overview from 1978 through 1996. J Am CollCardiol 1998;31:1650-7
9 Mikhail G, Gibbs J, Richardson M, Wright G, Khaghani A, Banner N, Yacoub M. An evaluation of nebulized prostacyclin in patients with primary and secondary pulmonary hypertension. Eur Heart J 1997;18: 1499-504
10 Voelkel NF, Tuder RM. Cellular and molecular mechanisms in the pathogenesis of severe pulmonary hypertension. Eur Respir J 1995;8(12):2129-38
11 Easterling TR, Ralph DD, Schmucker BC. Pulmonary hypertension in pregnancy: treatment with pulmonary vasodilators. Obstet Gynecol 1999;93:494-8
12 Christman BW, McPherson CD, Newman JH, King GA, Bernard GR, Groves BM, et al. An imbalance between the excretion of thromboxane and prostacyclin metabolites in pulmonary hypertension. N Engl J Med 1992;327:70-5
13 Barst RJ, Rubin LJ, Long WA, McGoon MD, Rich S, Badesch DB, et al. A comparison of continuous intravenous epoprostenol(prostacyclin) with conventional therapy for primary pulmonary hypertension: The Primary Pulmonary Hypertension Study Group. N Engl J Med 1996;334:296-302