Demographic and clinical characteristics of pulmonary arterial hypertension caused by schistosomiasis are indistinguishable from other etiologies

Abstract INTRODUCTION: Pulmonary arterial hypertension (PAH) is a serious pulmonary circulation disease caused by several etiologies, including schistosomiasis. The present study retrospectively evaluated the clinical and hemodynamic characteristics of patients with schistosomal PAH (PAH-Sch) compared to those of non-Sch PAH patients (non-Sch PAH). METHODS: Patients treated at the Pronto-Socorro Cardiológico de Pernambuco and diagnosed by right cardiac catheterization were divided into PAH-Sch and non-Sch PAH groups. Their socio-demographic and clinical characteristics, N-terminal-pro B-type natriuretic peptide (NT-proBNP), and echocardiography and hemodynamic parameters were retrospectively reviewed. RESULTS: Among the included 98 patients (mean age, 45 ± 14 years; 68 women [69.4%]), we found 56 PAH-Sch and 42 non-Sch PAH. The age distribution was heterogeneous in the PAH-Sch group, with patients predominantly ranging from 50-59 (p <0.004). Dyspnea was the most common symptom, reported by 92 patients (93.8%), and commonly present for over two years prior to diagnosis. Clinical symptoms were similar in both groups, with no differences in functional class, pulmonary artery systolic pressure (p = 0.102), 6-minute walk test score (p = 0.234), NT-proBNP serum levels (p = 0.081), or hemodynamic parameters. CONCLUSIONS: Patients with PAH-Sch present clinical, laboratory, and hemodynamic profiles similar to those with PAH resulting from other etiologies of poor prognosis. PAH is an important manifestation of schistosomiasis in endemic regions that is often diagnosed late.

Tratamento com stent em tronco de artéria coronária esquerda por compressão do tronco da artéria pulmonar em paciente com hipertensão pulmonar esquistossomótica / Stent treatment for a left main coronary artery compression by a dilated pulmonary trunk in a patient with schistosomotic pulmonary hypertension

A hipertensão arterial pulmonar frequentemente está associada a dor torácica com características anginosas e sua etiologia é desnconhecida. A compressão extrínseca do tronco de artéria coronária esquerda pela artéria pulmonar é uma causa tratável e deve ser considerada. É apresentado o caso de uma paciente com hipertensão arterial pulmonar de etiologia esquistossomótica, com angina do peito decorrente de compressão do tronco de artéria coronária esquerda, que foi tratada com stent intracoronário. Os sinais e sintomas isquêmicos foram completamente resolvidos e a ultrassonografia intracoronária, realizada na evolução tardia, mostrou a consolidação do resultado angiográfico.

Pulmonary hypertension is frequently associated to chest pain with anginous characteristics and its etiology is uncertain. Extrinsic compression of the left main coronary artery by the pulmonary artery is a treatable cause and should be taken into consideration. We present the case of a patient with pulmonary hypertension of schistosomotic etiology presenting angina due to compression of the left main coronary artery, who was treated with an intracoronary stent. Signs and symptoms of ischemia were completely resolved and a late follow-up intravascular ultrasound confirmed the vessel patency.

Hipertensão pulmonar associada à síndrome da imunodeficiência adquirida: apresentação de cinco casos e revisão da literatura / Pulmonary hypertension associated with acquired immunodeficiency syndrome: presentation of five cases and review of the literature

Diversas doenças cardiorespiratórias podem complicar a síndrome da imunodeficiência adquirida. A hipertensão pulmonar é uma rara doença com um pobre prognóstico. Nós descrevemos esta síndrome em cinco pacientes com infecção pelo vírus da imunodeficiência adquirida em nosso serviço com revisão da literatura.

Several cardiorespiratory diseases may complicate the acquired immunodeficiency syndrome. Pulmonary hypertension is a rare clinical disorder with a poor prognosis. We describe this syndrome in five patients seen at our service who presented infection with the acquired immunodeficiency virus, and we review the literature.