Use of Coils and a Pulmonary Vasodilator to Reduce Pulmonary Hypertension in a Patient with Interstitial Pneumonia and Scleroderma

Gusti Rizky Teguh Ryanto; Kazuhiko Nakayama; Tomofumi Takaya; Daichi Fujimoto; Hiroto Kinutani; Yuto Shinkura; Shumpei Mori; Takuya Okada; Tatsuya Nishii; Atsushi Kono; Toshiro Shinke; Noriaki Emoto; Ken-ichi Hirata

doi:10.2169/internalmedicine.54.4976

CASE REPORTS

Use of Coils and a Pulmonary Vasodilator to Reduce Pulmonary Hypertension in a Patient with Interstitial Pneumonia and Scleroderma

Gusti Rizky Teguh Ryanto, Kazuhiko Nakayama, Tomofumi Takaya, Daichi Fujimoto, Hiroto Kinutani, Yuto Shinkura, Shumpei Mori, Takuya Okada, Tatsuya Nishii, Atsushi Kono, Toshiro Shinke, Noriaki Emoto, Ken-ichi Hirata

Author information

Gusti Rizky Teguh Ryanto
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Faculty of Medicine, University of Indonesia, Indonesia
Kazuhiko Nakayama
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Tomofumi Takaya
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Daichi Fujimoto
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Hiroto Kinutani
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Yuto Shinkura
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Shumpei Mori
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Takuya Okada
Department of Radiology, Kobe University Graduate School of Medicine, Japan
Tatsuya Nishii
Department of Radiology, Kobe University Graduate School of Medicine, Japan
Atsushi Kono
Department of Radiology, Kobe University Graduate School of Medicine, Japan
Toshiro Shinke
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Noriaki Emoto
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Department of Clinical Pharmacy, Kobe Pharmaceutical University, Japan
Ken-ichi Hirata
Division of Cardivascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan

Keywords: systemic to pulmonary artery fistula, pulmonary hypertension, interstitial pneumonia, scleroderma, coils, pulmonary vasodilator

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 21 Pages 2721-2726

DOI https://doi.org/10.2169/internalmedicine.54.4976

Details

Abstract

Fistulas between systemic and pulmonary arteries are associated with various underlying etiologies and cause pulmonary hypertension (PH). Diagnosis of this condition requires several imaging studies and the exclusion of other possible causes of PH. We herein report a case of a patient with interstitial pneumonia and scleroderma. The imaging revealed multiple fistulas involving the inferior phrenic and left lower pulmonary arteries. The fistulas were closed using coils, but the PH remained presumably due to other undiagonosed fistulas. The improvement of symptoms following use of a supplementary pulmonary vasodilator provides the hope that the chosen treatment could be a viable alternative approach for other similar cases.

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