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Severe pulmonary hypertension in a young patient with end-stage renal disease on chronic hemodialysis

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Author(s): Sharma Satyavan | Kirpalani Ashok | Kulkarni Amit

Journal: Annals of Pediatric Cardiology
ISSN 0974-2069

Volume: 3;
Issue: 2;
Start page: 184;
Date: 2010;
Original page

Keywords: Arteriovenous fistula | end-stage renal disease | pulmonary artery hypertension | pulmonary circulation

ABSTRACT
Severe pulmonary hypertension in a teenager with end-stage renal disease on chronic hemodialysis via arteriovenous access is reported. Clinical presentation included persistent volume overload and pericardial effusion. Serial hemodynamic data obtained at cardiac catheterization confirmed the diagnosis. In addition, detailed biochemical and imaging data (echo- Doppler, computed tomography of chest, computed tomographic pulmonary angiography, VQ lung scan, etc.) were obtained to find out the mechanism. The exact cause of pulmonary hypertension remains unclear, and a multi- factorial mechanism is postulated. This rare case is presented to highlight the role of aggressive dialysis, pericardiocentesis, and use of sildenafil and bosentan in the management.
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