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Multidisciplinary approach to severe pulmonary arterial hypertension
Multidisciplinary approach to severe pulmonary arterial hypertension
Hans J. Cruz Bolaños 1 
, Alfredo Aisa-Álvarez 1 , Francisco J. González-Moreno 1 , Óscar Millán-Iturbe 2, David Faz-Muñoz 3
1 Servicio de Medicina Crítica, Centro Médico ABC, Ciudad de México, México; 2 Servicio de Cardiología, Centro Médico ABC, Ciudad de México, México; 3 Servicio de Reumatología, Centro Médico ABC, Ciudad de México, México
*Correspondence: Hans J. Cruz Bolaños. Email: hans_on14@hotmail.com
Abstract
We present the case of a 66-year-old woman with progressive dyspnea for 1 year, fingertip ulcers, and weight loss. In the multidisciplinary approach, computed tomography showed interstitial thickening. Respiratory function showed a restrictive pulmonary pattern and diffusion impairment. Pulmonary embolism was ruled out. Echocardiogram revealed a pulmonary artery systolic pressure of 90 mmHg, and right heart catheterization confirmed precapillary pulmonary hypertension with no response to vasodilator challenge, along with right heart failure and severe group I pulmonary hypertension. A diagnosis of systemic sclerosis was established. Immunosuppressive treatment and specific therapy for pulmonary hypertension were initiated.
Keywords: Pulmonary hypertension. Systemic sclerosis. Pulmonary arterial hypertension. Connective tissue diseases.
