Tratamento com stent em tronco de artéria coronária esquerda por compressão do tronco da artéria pulmonar em paciente com hipertensão pulmonar esquistossomótica

Abstract

Relato de Caso RESUMO A hipertensão arterial pulmonar frequentemente está associada a dor torácica com características anginosas e sua etiologia é desconhecida. A compressão extrínseca do tronco de artéria coronária esquerda pela artéria pulmonar é uma causa tratável e deve ser considerada. É apresentado o caso de uma paciente com hipertensão arterial pulmonar de etiologia esquistossomótica, com angina do peito decorrente de compressão do tronco de artéria coronária esquerda, que foi tratada com stent intracoronário. Os sinais e sintomas isquêmicos foram completamente resolvidos e a ultrassonografia intracoronária, realizada na evolução tardia, mostrou a consolidação do resultado angiográfico.

Perfil hemodinâmico de gravidade ao teste de vasorreatividade pulmonar em esquistossomóticos

“…There are also prognostic information through measurements of hemodynamic variables that are associated with disease severity and risk of death, such as increased mean right atrial pressure, increased pulmonary artery pressure, decreased cardiac index, increased pulmonary vascular resistance, decreased oxygen saturation in the pulmonary artery, and others 2,11 . By means of coronary angiography, one can also diagnose extrinsic compression of the left main coronary artery by the pulmonary artery, an entity that has been increasingly described in severe PAH 12 .…”

Schistosomiasis-associated pulmonary arterial hypertension: a systematic review

“…-analysis (table E4)[86][87][88]. Haemodynamic data from 11 clinical registries on iPAH, including a total of 3532 patients, were utilised for comparison(table E5)[16,60,81,[89][90][91][92][93][94][95][96].Haemodynamics from single studies and grand means of all included studies in Sch-PAH are given intable E6; those for iPAH are given in table E7.…”

Demographic and clinical characteristics of pulmonary arterial hypertension caused by schistosomiasis are indistinguishable from other etiologies

“…Another with PAH-Sch presented with complete compression of the trunk of the left coronary artery, which was treated with a stent. The patient remained symptom free and showed good long-term outcomes, being the first case with this type of PAH-Sch treatment described in the literature 24 . Although chest pain is present in diverse clinical situations, it is always recommended that coronary angiography be performed in those with this symptom or who have significant dilatation in the large pulmonary branches [25][26] .…”