Pulmonary hypertensive crisis and its efficient management. A Case report and literature review

J Pak Med Assoc. 2017 Jun;67(6):936-938.

Abstract

Perioperative anaesthetic management of patients with pulmonary hypertensive crisis is complex and challenging because of limited window period and treatment options. This case report describes the successful management of a patient with severe valvular heart disease superimposed by severe pulmonary hypertension, who developed pulmonary hypertensive crisis soon after induction of general anaesthesia for cardiac surgery. Pulmonary hypertensive crisis is not a usual phenomenon in these patients, but if it occurs it can be fatal. Anticipatory care of the patient to prevent crisis is the mainstay of treatment, otherwise it adds additional morbidity to such patients. Fortunately our patient survived the crisis without causing any additional morbidity during his hospital stay.

Keywords: Pulmonary hypertensive crisis, General anaesthesia, Perioperative management, Severe pulmonary hypertension..

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Inhalation
  • Alprostadil / therapeutic use*
  • Anesthesia, General / methods*
  • Aortic Valve Stenosis / surgery
  • Heart Valve Prosthesis Implantation
  • Humans
  • Hypertension, Pulmonary / therapy*
  • Male
  • Middle Aged
  • Mitral Valve Stenosis / surgery
  • Oxygen Inhalation Therapy
  • Perioperative Care / methods*
  • Severity of Illness Index
  • Vasodilator Agents / therapeutic use*

Substances

  • Vasodilator Agents
  • Alprostadil