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McHugh S, Vanchiere C, Oliveros E, Islam S, Luceno S, Vaidya A, Forfia P. Malignancy-Related Pulmonary Hypertension Presenting as a Pulmonary Veno-Occlusive-Like Syndrome: A Single-Center Case Series. JACC Case Rep 2021; 3:1044-1050. [PMID: 34317681 PMCID: PMC8311357 DOI: 10.1016/j.jaccas.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/19/2021] [Accepted: 04/09/2021] [Indexed: 11/11/2022]
Abstract
Tumoral obstruction is a small, but broadly defined, category of pulmonary hypertension that encompasses microvascular tumor emboli, tumor thrombotic microangiopathy, and macrovascular tumor obstruction within the pulmonary circulation. We present 4 patients with solid tumors, severe pre-capillary pulmonary hypertension, right ventricular failure, and pulmonary veno-occlusive–like disease. (Level of Difficulty: Advanced.)
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Key Words
- AF, atrial fibrillation
- CT, computed tomography
- CTEPH, chronic thromboembolic pulmonary hypertension
- IV, intravenous
- LAP, left atrial pressure
- PH, pulmonary hypertension
- PVOD
- PVOD, pulmonary veno-occlusive disease
- PVR, pulmonary vascular resistance
- RV, right ventricle
- TTE, transthoracic echocardiogram
- cancer
- malignancy
- pulmonary hypertension
- pulmonary veno-occlusive disease
- tumor
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Affiliation(s)
- Stephen McHugh
- Department of Internal Medicine, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Catherine Vanchiere
- Department of Internal Medicine, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Estefania Oliveros
- Department of Cardiology, Temple University Hospital, Philadelphia, Pennsylvania, USA.,Pulmonary Hypertension, Right Heart Failure, and CTEPH Program, Department of Cardiology, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Sabrina Islam
- Department of Cardiology, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Salvatore Luceno
- Department of Pathology, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Anjali Vaidya
- Department of Cardiology, Temple University Hospital, Philadelphia, Pennsylvania, USA.,Pulmonary Hypertension, Right Heart Failure, and CTEPH Program, Department of Cardiology, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Paul Forfia
- Department of Cardiology, Temple University Hospital, Philadelphia, Pennsylvania, USA.,Pulmonary Hypertension, Right Heart Failure, and CTEPH Program, Department of Cardiology, Temple University Hospital, Philadelphia, Pennsylvania, USA
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Day RW, Clement PW, Hersh AO, Connors SM, Sumner KL, Best DH, Alashari M. Pulmonary veno-occlusive disease: Two children with gradual disease progression. Respir Med Case Rep 2017; 20:82-86. [PMID: 28070482 PMCID: PMC5219617 DOI: 10.1016/j.rmcr.2016.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 12/27/2016] [Accepted: 12/27/2016] [Indexed: 11/26/2022] Open
Abstract
Pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis are rare forms of pulmonary vascular disease. We report two cases of affected children who had evidence of pulmonary hypertension 3–5 years before developing radiographic findings of pulmonary veno-occlusive disease or pulmonary capillary hemangiomatosis. Both patients experienced a moderate decrease in pulmonary arterial pressure during acute vasodilator testing. Both patients experienced an improvement in six-minute walk performance without an increase in pulmonary edema when treated with targeted therapy for pulmonary hypertension. In some patients, pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis may progress slowly over a period of months to years. A favorable acute vasodilator response may identify patients who will tolerate, and demonstrate transient clinical improvement with, medical therapy.
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Affiliation(s)
- Ronald W Day
- University of Utah Department of Pediatrics, 81 North Mario Capecchi Drive, Salt Lake City, UT 84113, USA
| | - Parker W Clement
- University of Utah Department of Pathology, 15 North Medical Drive, Suite 1100, Salt Lake City, UT 84132, USA
| | - Aimee O Hersh
- University of Utah Department of Pediatrics, 81 North Mario Capecchi Drive, Salt Lake City, UT 84113, USA
| | - Susan M Connors
- Vascular Biology Program of Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Kelli L Sumner
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, USA
| | - D Hunter Best
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Mouied Alashari
- University of Utah Department of Pathology, 15 North Medical Drive, Suite 1100, Salt Lake City, UT 84132, USA
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