Combined Pulmonary Fibrosis and Emphysema With Pulmonary Hypertension: Cases Report

Curr Probl Cardiol. 2022 Apr;47(4):100856. doi: 10.1016/j.cpcardiol.2021.100856. Epub 2021 Apr 15.

Abstract

Background: The combination of pulmonary fibrosis and emphysema (CPFE) has been recently defined as a syndrome, it is radiologically recognized and is characterized by the simultaneous coexistence of emphysema of superior pulmonary location and fibrosis predominantly in lower lobes.

Case presentation: We present three patients with CPFE, who underwent right cardiac catheterization for pulmonary hemodynamic assessment, finding mean pulmonary artery pressure (mPAP) between 37-52 mm Hg (mean 45 mm Hg), who received treatment with specific vasodilators for pulmonary arterial hypertension (PAH).

Discussion and conclusions: The three patients had higher mPAP than expected for Group III (Pulmonary hypertension due to lung disease and/or hypoxia) of the classification of pulmonary hypertension (PH) by the World Health Organization (WHO), in whom the use of Sildenafil was justified by the presence of progressive dyspnea, and no symptoms suggestive of infectious exacerbation associated with right ventricular failure.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cardiac Catheterization
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / drug therapy
  • Hypertension, Pulmonary / etiology
  • Pulmonary Arterial Hypertension* / diagnosis
  • Pulmonary Arterial Hypertension* / drug therapy
  • Pulmonary Arterial Hypertension* / etiology
  • Pulmonary Emphysema* / complications
  • Pulmonary Emphysema* / diagnosis
  • Pulmonary Emphysema* / diagnostic imaging
  • Pulmonary Fibrosis* / complications
  • Pulmonary Fibrosis* / diagnosis
  • Pulmonary Fibrosis* / diagnostic imaging
  • Sildenafil Citrate / therapeutic use
  • Vasodilator Agents / therapeutic use

Substances

  • Vasodilator Agents
  • Sildenafil Citrate