European Heart Journal: Case Reports最新文献_第10页

Balloon inflation for a mechanical tricuspid valve thrombosis: case report. 球囊充气治疗机械性三尖瓣血栓1例报告。

IF 0.8

European Heart Journal: Case Reports Pub Date : 2025-07-31 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf367

Shaw Hua Anthony Kueh, Mark Webster

{"title":"Balloon inflation for a mechanical tricuspid valve thrombosis: case report.","authors":"Shaw Hua Anthony Kueh, Mark Webster","doi":"10.1093/ehjcr/ytaf367","DOIUrl":"10.1093/ehjcr/ytaf367","url":null,"abstract":"Background: Mechanical valve thrombosis (MVT) is rare but life-threatening complication. While the clinical guideline suggests that thrombolysis for high-risk surgical candidates should be considered, the European guideline does not differentiate between left- and right-sided MVTs while the American guideline only made specific recommendations for left-sided MVT. Furthermore, the American guideline suggests that percutaneous intervention for left-sided MVT may be considered. Both clinical guidelines did not refer to percutaneous intervention for right-sided MVT.Case summary: A 52-year-old woman with three mechanical valve replacements for rheumatic heart disease presented with subacute onset of symptoms of right-sided heart failure. Transthoracic echocardiogram (TTE) demonstrated a high transvalvular gradient across the tricuspid mechanical valve which is new from TTE 3 years prior. Further imaging confirmed thrombosis of the anterior leaflet of the tricuspid mechanical valve. Four cycles of ultra-low-dose thrombolysis and one standard-dose thrombolysis failed to restore normal valve function. Surgery was considered prohibitively high-risk, and the patient was left with either palliation or percutaneous intervention. Percutaneous mechanical valve balloon inflation was undertaken with subsequent improvement in transvalvular gradient and leaflet motion.Discussion: There is limited data on percutaneous intervention for right-sided MVT with only one other case reported to date. In patients with prohibitively high surgical risk, thrombolysis should be considered as per the clinical guidelines. However, in ∼1 in 10 patients, thrombolysis fails to restore normal valve function. Percutaneous intervention may be an alternative option.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf367"},"PeriodicalIF":0.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Arteriovenous fistula in the aortic arch: a case report involving 3D models for surgical planning. 主动脉弓内动静脉瘘：应用三维模型进行手术计划一例报告。

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European Heart Journal: Case Reports Pub Date : 2025-07-30 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf362

Clara Isabel Perez, Lore Lakunza, Alberto Saenz, Roberto Voces, Ignacio Gallo

{"title":"Arteriovenous fistula in the aortic arch: a case report involving 3D models for surgical planning.","authors":"Clara Isabel Perez, Lore Lakunza, Alberto Saenz, Roberto Voces, Ignacio Gallo","doi":"10.1093/ehjcr/ytaf362","DOIUrl":"10.1093/ehjcr/ytaf362","url":null,"abstract":"Background: Traumatic arteriovenous fistulas involving the thoracic aorta are rare. Their closure remains a challenge for the surgeon due to the vascular changes involved. We aim to highlight the benefits of 3D models and virtual three-dimensional reconstruction when used as a complementary tool in surgical planning.Case summary: We present the case of a 38-year-old male patient with a history trauma from a localized bombing, resulting in shrapnel impact to his thorax. He came for surgical treatment due to a diagnosis of arteriovenous fistula at the level of the aortic arch. For surgical planning, two 3D models (with FDM and PolyJet technology) were made to assess the anatomical relationship between the aorta, the left brachiocephalic vein, the fistulous tract and the sternum. The patient was successfully operated on.Discussion: Surgical repair of thoracic fistulas is highly complex, requiring a multi-disciplinary approach and advanced imaging for accurate diagnosis and planning. Procedures are often performed under cardiopulmonary bypass and hypothermia to enhance safety, especially in challenging scenarios. These fistulas frequently cause vascular overload and degenerative venous changes, increasing the risk of haemorrhage and complicating dissection. 3D technology significantly improves surgical planning by enabling accurate fistula localization, guiding sternotomy, simulating procedures, and mapping vascular anomalies. PolyJet models, in particular, provide superior anatomical insight. Thus, 3D modelling serves as a complementary tool that provides life-size, detailed anatomical information of the patient, facilitating better pre-operative surgical planning, and carrying the potential to reduce operative risks.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf362"},"PeriodicalIF":0.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Flecainide fallout: a rare case report of refractory ventricular tachycardia and updated management strategies. 弗莱卡因放射物：难治性室性心动过速罕见病例报告及最新的治疗策略。

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European Heart Journal: Case Reports Pub Date : 2025-07-29 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf368

Abhishek Kumar, Manisha Gupta, Amratansh Varshney, Rounak Kumar

{"title":"Flecainide fallout: a rare case report of refractory ventricular tachycardia and updated management strategies.","authors":"Abhishek Kumar, Manisha Gupta, Amratansh Varshney, Rounak Kumar","doi":"10.1093/ehjcr/ytaf368","DOIUrl":"10.1093/ehjcr/ytaf368","url":null,"abstract":"Background: Flecainide is a Class IC antiarrhythmic drug used to treat arrhythmias such as atrial fibrillation (AF), paroxysmal supraventricular tachycardia, and ventricular tachycardia (VT). Its mechanism involves blocking sodium channels, leading to QRS widening, especially at higher heart rates. This property increases the risk of pro-arrhythmic events, particularly in patients with structural heart disease or ischaemia.Case summary: A 67-year-old woman receiving flecainide for AF suffered an ischaemic stroke and later developed VT resistant to amiodarone and direct current cardioversion. Her condition improved significantly after intravenous sodium bicarbonate was administered, which counteracted the effects of sodium channel blockade. Later, she was found to have hyponatremia and slightly elevated flecainide values above the upper limit. This case highlights the complexities of flecainide therapy and the importance of timely intervention in managing arrhythmias.Discussion: This case underscores the arrhythmogenic potential of flecainide. The development of VT suggests that flecainide may have created a substrate for arrhythmias due to its effects on cardiac conduction. The successful use of sodium bicarbonate illustrates an effective treatment strategy for reversing flecainide-induced toxicity. Clinicians should remain vigilant and consider alternative therapies in managing patients at risk for arrhythmias while on flecainide.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf368"},"PeriodicalIF":0.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Iatrogenic acute coronary occlusion during epicardial ventricular tachycardia ablation: when intravascular imaging guides the management-a case report. 心外膜室性心动过速消融期间的医源性急性冠状动脉闭塞：当血管内成像指导治疗时- 1例报告。

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European Heart Journal: Case Reports Pub Date : 2025-07-28 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf358

Filippo Russo, Ciro Vella, Filippo Maria Cauti, Vittorio Romano, Marco Gamardella, Marco Bruno Ancona, Alaide Chieffo, Matteo Montorfano

引用次数: 0

Biventricular takotsubo syndrome complicated with cardiogenic shock and shark fin sign requiring ECPELLA: a case report. 双心室takotsubo综合征合并心源性休克和鱼翅征需要ECPELLA: 1例报告。

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European Heart Journal: Case Reports Pub Date : 2025-07-28 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf366

Kanta Takeda, Ryohei Ono, Ken Kato, Togo Iwahana, Yoshio Kobayashi

{"title":"Biventricular takotsubo syndrome complicated with cardiogenic shock and shark fin sign requiring ECPELLA: a case report.","authors":"Kanta Takeda, Ryohei Ono, Ken Kato, Togo Iwahana, Yoshio Kobayashi","doi":"10.1093/ehjcr/ytaf366","DOIUrl":"10.1093/ehjcr/ytaf366","url":null,"abstract":"Background: Takotsubo syndrome (TTS) is a transient cardiac condition primarily affecting left ventricular function and is often triggered by physical or emotional stress. Biventricular involvement in TTS has been recently reported, and such cases are associated with a more severe clinical presentation. However, biventricular TTS with cardiogenic shock (CS) requiring mechanical circulatory support (MCS) is rare. Furthermore, shark fin sign (SFS) is a distinctive electrocardiographic pattern typically associated with significant myocardial ischaemia, but SFS associated with TTS has seldom been reported.Case summary: A 77-year-old woman with sepsis and pyelonephritis presented with fever and chest pain. An initial electrocardiogram showed SFS. Transthoracic echocardiography revealed a severely reduced left ventricular ejection fraction with apical ballooning, akinesis of the apical free-wall segment, and hyperkinesia of the basal segments of the right ventricle. Impella® was inserted for CS, but the shock persisted due to severe right ventricular (RV) dysfunction, and she required veno-arterial extracorporeal membrane oxygenation. After the treatments, her cardiac functions improved, and MCS was weaned off. The follow-up findings of electrocardiographic changes and Thallium-201 and iodine-123-metaiodobenzylguanidine (MIBG) myocardial scintigraphy were consistent with TTS.Discussion: In the case of biventricular TTS with CS, the use of MCS for RV support may be required. Shark fin sign may be associated with haemodynamic instability or shock even in TTS. Furthermore, repeated myocardial scintigraphy is useful for diagnosing TTS because the acute phase shows preserved myocardial perfusion with markedly reduced MIBG uptake indicating impaired sympathetic innervation, whereas the chronic phase shows improvement in MIBG uptake.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf366"},"PeriodicalIF":0.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of adrenaline in comprehensive management of electrical storms in high-risk Brugada syndrome with rare SCN5A mutation: a case report from medical stabilization to implantable cardioverter-defibrillator implantation. 肾上腺素在伴有罕见SCN5A突变的高危Brugada综合征电风暴综合治疗中的作用：从医疗稳定到植入式心律转复除颤器植入术1例报告

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European Heart Journal: Case Reports Pub Date : 2025-07-28 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf364

Duy Thai Vo, Dat Cao Tran, Dung Ngoc Kieu, Thuc Tri Nguyen, Binh Thi Thanh Dao

{"title":"The role of adrenaline in comprehensive management of electrical storms in high-risk Brugada syndrome with rare SCN5A mutation: a case report from medical stabilization to implantable cardioverter-defibrillator implantation.","authors":"Duy Thai Vo, Dat Cao Tran, Dung Ngoc Kieu, Thuc Tri Nguyen, Binh Thi Thanh Dao","doi":"10.1093/ehjcr/ytaf364","DOIUrl":"10.1093/ehjcr/ytaf364","url":null,"abstract":"Background: Patients with Brugada syndrome (BrS) have a risk of sudden cardiac death, often linked to mutations in the SCN5A gene. Electrical storms (ESs) in this population are life-threatening and typically require urgent administration of isoproterenol; however, in resource-limited settings, alternative pharmacologic strategies may be required. The management of ES in BrS is complex and often relies on case reports due to the rarity of the condition.Case summary: A 50-year-old male with no prior medical history presented with sudden cardiac arrest during a social event. Following successful resuscitation and multiple defibrillations for ventricular fibrillation, the patient was transferred to our centre with an ECG showing a spontaneous type 1 Brugada pattern. Despite therapy with multiple antiarrhythmic agents including amiodarone and lidocaine, the patient experienced recurrent episodes of ventricular fibrillation. In the absence of isoproterenol, low-dose adrenaline infusion was initiated, resulting in prompt termination of ES. A single-chamber implantable cardioverter-defibrillator was subsequently implanted in combination with quinidine and cilostazol for long-term suppression of arrhythmic events and prevention of recurrent ES. Genetic testing revealed two SCN5A mutations [c.4744C>T (p.Arg1582Cys) and c.3067C>T (p.Arg1023Cys)]; the first has not been previously reported in BrS.Discussion: This case underscores the potential utility of adrenaline as an accessible and effective alternative in the acute management of ES in BrS patients, if isoproterenol is unavailable. It also highlights the importance of genetic evaluation in BrS for tailored therapeutic strategies.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf364"},"PeriodicalIF":0.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Streamlined concomitant pulse field ablation-based pulmonary vein isolation and left atrial appendage occlusion via a single venous access approach: a case report. 单静脉入路流线伴随脉冲场消融肺静脉隔离和左心房附件闭塞1例报告。

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European Heart Journal: Case Reports Pub Date : 2025-07-26 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf350

Christian-H Heeger, Henning Rolfes, Lena Böttcher, Felix Meincke, Martin W Bergmann

{"title":"Streamlined concomitant pulse field ablation-based pulmonary vein isolation and left atrial appendage occlusion via a single venous access approach: a case report.","authors":"Christian-H Heeger, Henning Rolfes, Lena Böttcher, Felix Meincke, Martin W Bergmann","doi":"10.1093/ehjcr/ytaf350","DOIUrl":"10.1093/ehjcr/ytaf350","url":null,"abstract":"Background: Pulsed field ablation (PFA) is a novel non-thermal cardiac ablation method utilizing irreversible electroporation which has been introduced especially for treatment of atrial fibrillation (AF) by pulmonary vein isolation (PVI). Interventional left atrial appendage closure (LAAC) is an alternative to oral anticoagulation (OAC) in patients with non-valvular AF and high stroke risk who are ineligible for OAC. A concomitant PVI and LAAC might be beneficial for patients.Case summary: In an 82-year-old male patient with symptomatic persistent AF, CHA2DS2-VA Score of 4 and HASBLED Score of 3 due to previous gastrointestinal bleeding were scheduled for a concomitant PVI + LAAC procedure. For minimum risk, a streamlined approach utilizing a single femoral vein puncture in combination with a suture-based closure system (Perclose Prostyle, Abbott) was performed. The transoesophageal echocardiography (TOE) LAA landing zone measurements were achieved directly prior ablation. Pulmonary vein isolation was performed with pentaspline PFA catheter (FARAPULSE). Although a swelling of the left atrial ridge was observed, a 24 mm WATCHMAN FLX device was successfully implanted. The patient was mobilized after 2 h and discharged on the next day. After 2 months on OAC, TOE found no gaps or leakage of the LAAC device and OAC was switched to acetylsalicylic acid monotherapy.Discussion: A streamlined concomitant PFA-based PVI and LAAC procedure utilizing FARAPULSE and WATCHMAN FLX devices seems to be feasible and safe. Swelling of the ridge after PVI was observed; however, the sizing measurements have been performed prior PVI, and the LAAC procedure was successful with no evidence for gaps or leakage. A concomitant approach might be a suitable option for selected patients.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf350"},"PeriodicalIF":0.8,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiac amyloidosis associated with marginal zone lymphoma. 心脏淀粉样变与边缘区淋巴瘤相关。

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European Heart Journal: Case Reports Pub Date : 2025-07-25 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf359

Chinmay Parale, Hrishikesh Parale, Gurunath Parale

引用次数: 0

Successful transcatheter mitral valve repair for mitral regurgitation complicating fulminant eosinophilic myocarditis: a case report. 经导管二尖瓣修复成功治疗二尖瓣返流合并暴发性嗜酸性心肌炎1例。

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European Heart Journal: Case Reports Pub Date : 2025-07-25 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf353

Yudai Shiwaku, Tatsuya Aonuma, Yuya Kitani, Toshiharu Takeuchi, Nakagawa Naoki

{"title":"Successful transcatheter mitral valve repair for mitral regurgitation complicating fulminant eosinophilic myocarditis: a case report.","authors":"Yudai Shiwaku, Tatsuya Aonuma, Yuya Kitani, Toshiharu Takeuchi, Nakagawa Naoki","doi":"10.1093/ehjcr/ytaf353","DOIUrl":"10.1093/ehjcr/ytaf353","url":null,"abstract":"Background: Fulminant eosinophilic myocarditis (EM) has a poor prognosis. Acute severe mitral regurgitation (MR) is a life-threatening complication of EM: however, no established treatment thereof exists.Case summary: Herein, we report a case of a 70-year-old woman diagnosed with fulminant EM. She was in cardiogenic shock and treatment was initiated with an implanted intra-aortic balloon pump in addition to steroids and inotropes. Functional MR gradually worsened, and cardiogenic shock did not improve. Our cardiology team discussed the treatment plan and performed transcatheter mitral valve repair (TMVr). Immediately after the procedure, MR was well-controlled, and the patient's hemodynamics improved dramatically. After discharge, there was no recurrence of heart failure.Discussion: We identified two important clinical issues: first, acute functional MR requiring invasive treatment can be associated with fulminant EM; and second, TMVr is useful as an invasive treatment strategy for such MR. Although MR caused by EM improves with pharmacological therapies in many cases, invasive treatment strategies may be required in some case, as seen in this case. Compared with surgeries, TMVr is less invasive and carries a lower risk of postoperative low cardiac output syndrome compared with surgical procedures when MR is well-controlled. If the response to pharmacological therapies is poor, early TMVr should be considered.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf353"},"PeriodicalIF":0.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges in accurately assessing acute vasoreactivity in paediatric pulmonary arterial hypertension: case reports highlighting the impact of sedation on diagnostic accuracy. 准确评估儿科肺动脉高压急性血管反应性的挑战：病例报告强调镇静对诊断准确性的影响。

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European Heart Journal: Case Reports Pub Date : 2025-07-25 eCollection Date: 2025-08-01 DOI: 10.1093/ehjcr/ytaf357

Kana Inoue, Taku Ishii, Yohei Yamaguchi, Satoshi Nagahara, Makito Sakurai, Susumu Hosokawa, Shozaburo Doi

{"title":"Challenges in accurately assessing acute vasoreactivity in paediatric pulmonary arterial hypertension: case reports highlighting the impact of sedation on diagnostic accuracy.","authors":"Kana Inoue, Taku Ishii, Yohei Yamaguchi, Satoshi Nagahara, Makito Sakurai, Susumu Hosokawa, Shozaburo Doi","doi":"10.1093/ehjcr/ytaf357","DOIUrl":"10.1093/ehjcr/ytaf357","url":null,"abstract":"Background: Initial treatment based on acute vasoreactivity test results is essential for idiopathic or hereditary pulmonary arterial hypertension. In paediatric patients who are usually examined under sedation, accurately identifying those who are positive in the acute vasoreactivity test is often difficult.Case summary: Patient 1: A 10-year-old boy was diagnosed with heritable pulmonary arterial hypertension at the age of 5 years, following symptoms of exertional dyspnoea and fatigue. During the initial right heart catheterization, his mean pulmonary artery pressure was 21 mmHg under sedation. After pulmonary hypertension-targeted therapy was initiated, symptoms improved. However, during a follow-up examination at 10 years of age, the patient was awake, causing the pulmonary artery pressure to rise from 33/10 (21) to 99/55 (70) mmHg. Nonetheless, under nitric oxide inhalation, the rise in pulmonary artery pressure was minimal, even when the patient was awake. Subsequently, he responded well to calcium channel blockers. Patient 2: A 5-year-old girl experienced syncope and exertional cyanosis. Under sedation, initial right heart catheterization showed a pulmonary artery pressure of 44/15 (27) mmHg, which increased to 82/49 (57) mmHg upon awakening and reduced to 38/12 (22) mmHg after nitric oxide inhalation. Diagnosed with idiopathic pulmonary arterial hypertension positive for the acute vasoreactivity test, she responded well to calcium channel blockers.Discussion: Acute vasoreactivity test may be potentially underestimated during sedation in paediatric patients with pulmonary arterial hypertension. Thus, evaluating pulmonary artery pressure by reducing anaesthesia depth or stimulating wakefulness can lead to an appropriate diagnosis and treatment.","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 8","pages":"ytaf357"},"PeriodicalIF":0.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0