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Complete resolution of chronic pericardial effusion with an intensive course of inhaled iloprost in an adult patient with unrepaired ventricular septal defect, and life-threatening severe pulmonary arterial hypertension.

Abstract
A 38-year-old male was diagnosed with unrepaired ventricular septal defect associated with severe pulmonary arterial hypertension, cyanosis, and significant exercise intolerance. His echocardiogram showed right ventricular dysfunction and moderate pericardial effusion with no signs of cardiac tamponade. He was treated with an intensive course of inhaled iloprost and sildenafil. He showed a dramatic clinical response; his saturation went up from 60% on admission to 90% on minimal oxygen with significant improvement in his symptoms and signs of heart failure and total resolution of pericardial effusion. On follow up 3 and 6 weeks later, he was stable and could walk 360 meters in a 6 minutes walk test with disappearance of pericardial effusion. With unavailability of intravenous prostacyclin, we have shown in this case that intensive administration of inhaled iloprost could be used intensively as a rescue therapy in severe cases of pulmonary arterial hypertension with excellent results. 
AuthorsAhmed M Alzahrani, Abdullah S Alqahtani, Khalid S Alnajashi, Majdy M Idrees
JournalSaudi medical journal (Saudi Med J) Vol. 35 Issue 10 Pg. 1257-9 (Oct 2014) ISSN: 0379-5284 [Print] Saudi Arabia
PMID25316472 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Piperazines
  • Purines
  • Sulfonamides
  • Vasodilator Agents
  • Sildenafil Citrate
  • Iloprost
Topics
  • Administration, Inhalation
  • Adult
  • Exercise Test
  • Heart Septal Defects, Ventricular (complications)
  • Humans
  • Hypertension, Pulmonary (drug therapy, etiology)
  • Iloprost (therapeutic use)
  • Male
  • Pericardial Effusion (drug therapy, etiology)
  • Pericarditis (drug therapy, etiology)
  • Piperazines (therapeutic use)
  • Purines (therapeutic use)
  • Sildenafil Citrate
  • Sulfonamides (therapeutic use)
  • Treatment Outcome
  • Vasodilator Agents (therapeutic use)

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