case_images: PMC10893771_01
case_images: The patient's chest radiograph obtained on admission
case_images: cureus-0016-00000052907-i01.jpg
case_images: PMC10893771_01_cureus-0016-00000052907-i01.jpg
case_images: FIG1
case_images: Chest radiography displayed cardiac enlargement (Figure 1), and echocardiography displayed preserved contractility with no evidence of valvular disease. Chest radiography revealed cardiomegaly and scoliosis, with a Cobb angle of 28  (Figures 1-2).
case_images: The patient's chest computerized tomography obtained on admission
case_images: cureus-0016-00000052907-i02.jpg
case_images: PMC10893771_01_cureus-0016-00000052907-i02.jpg
case_images: FIG2
case_images: A CT scan of the chest showed no abnormality in the lung field and pulmonary artery enlargement (Figure 2), but no thrombus was found in the pulmonary artery on chest contrast-enhanced CT; therefore, pulmonary arterial hypertension was suspected, and the patient was admitted to the hospital. Chest radiography revealed cardiomegaly and scoliosis, with a Cobb angle of 28  (Figures 1-2).
case_images: Transcutaneous carbon dioxide (TcPCO2) monitoring during non-invasive positive pressure ventilation (IPAP/EPAP: 15/5 cmH2O, FiO2: 30%, RR: 20 cycles/min). The upper part of the TcPCO2 curve is the actual value and the lower part is the corrected difference from PaCO2.. IPAP: inspiratory positive airway pressure; EPAP: expiratory positive airway pressure; cmH2O: centimeter of water;  FiO2: fraction of inspired oxygen; RR: respiratory rate; PaCO2: artial pressure of carbon dioxide
case_images: cureus-0016-00000052907-i03.jpg
case_images: PMC10893771_01_cureus-0016-00000052907-i03.jpg
case_images: FIG3
case_images: TcPCO2 was above 70 mmHg to assess her level of consciousness, even at night. The TcPCO2 monitoring on the fifth day after extubating is displayed in Figure 3.
case_images: Polysomnography performed in two hours during daytime napping. REM: rapid eye movement; Cn.A: central apnea; Ob.A: obstructive apnea; Mx.A: mixed apnea; Hyp: hypopnea; TcPCO2: transcutaneous carbon dioxide; SpO2: oxygen saturation
case_images: cureus-0016-00000052907-i04.jpg
case_images: PMC10893771_01_cureus-0016-00000052907-i04.jpg
case_images: FIG4
case_images: The results of the two-hour PSG demonstrated an apnea/hypopnea index of 35/h, all of which were hypopneas (Figures 4-5).
case_images: Electromyograph recording during polysomnography. The waveform of chest motion is smaller than that of the abdomen in rapid eye movement (REM) sleep. This waveform can be considered a "pseudo-central event.". Hyp: hypopnea; Desat: desaturate; SpO2: oxygen saturation
case_images: cureus-0016-00000052907-i05.jpg
case_images: PMC10893771_01_cureus-0016-00000052907-i05.jpg
case_images: FIG5
case_images: The results of the two-hour PSG demonstrated an apnea/hypopnea index of 35/h, all of which were hypopneas (Figures 4-5).