case_images: PMC5820626_01
case_images: (a) Tricuspid regurgitation signal on echocardiogram at 25 weeks of gestation showing peak velocity of 5.38 m/s and Pulmonary Artery Systolic Pressure (PASP) of 120 mm Hg. (b) Echocardiogram at 25 weeks of gestation showing enlarged right ventricle and D-shaped left ventricle.
case_images: CRIPU2018-7031731.001.jpg
case_images: PMC5820626_01_CRIPU2018-7031731.001.jpg
case_images: fig1
case_images: Following admission, her ECHO showed a RVSP that had increased from 80 mm Hg, noted on her ECHO at 13 weeks of gestation, to 120 mm Hg (Figures 1(a) and 1(b)). PAH specific therapy slowly improved the patient's hemodynamic parameters (Figure 2 and Table 1). PAH specific therapy initially was limited to intravenous epoprostenol, but, upon normalization of LFTs, macitentan was initiated and as PA pressure gradually trended down to 80 mmHg and her blood pressure improved, sildenafil was added.
case_images: Graph representing changes in pulmonary artery systolic pressure, cardiac output, and central venous pressure after initiation of extracorporeal membrane oxygenation. CVP, central venous pressure; PASP, pulmonary artery systolic pressure; CO, cardiac output.
case_images: CRIPU2018-7031731.002.jpg
case_images: PMC5820626_01_CRIPU2018-7031731.002.jpg
case_images: fig2
case_images: PAH specific therapy slowly improved the patient's hemodynamic parameters (Figure 2 and Table 1). PAH specific therapy initially was limited to intravenous epoprostenol, but, upon normalization of LFTs, macitentan was initiated and as PA pressure gradually trended down to 80 mmHg and her blood pressure improved, sildenafil was added.