Krenz Elizabeth I, Hart Stuart R, Russo Melissa, Alkadri Mohi
Ochsner J. 2011 Spring;11(1):78-80.
A 38-year-old woman with severe pulmonary artery hypertension and a right-to-left shunt of unknown etiology presented at 32 weeks' gestational age. Determination of the cause of her pulmonary hypertension by transesophageal echocardiography was delayed until after delivery secondary to anesthetic risk. She was successfully anesthetized for cesarean delivery using epidural anesthesia. Systemic vascular resistance was maintained using phenylephrine hydrochloride before delivery and vasopressin after delivery. Transesophageal echocardiography after delivery revealed a patent foramen ovale, indicating a diagnosis of idiopathic pulmonary artery hypertension and a very poor prognosis. Differentiating between Eisenmenger syndrome and idiopathic pulmonary artery hypertension may not be important for determining the optimal anesthetic management of patients with pulmonary hypertension but is important in assessing long-term prognosis.
一名38岁患有严重肺动脉高压且病因不明的右向左分流的女性，在孕32周时就诊。由于麻醉风险，经食管超声心动图确定其肺动脉高压病因的检查推迟至分娩后。她通过硬膜外麻醉成功接受剖宫产手术麻醉。分娩前使用盐酸去氧肾上腺素维持体循环阻力，分娩后使用血管加压素。分娩后经食管超声心动图显示卵圆孔未闭，提示特发性肺动脉高压诊断且预后极差。区分艾森曼格综合征和特发性肺动脉高压对于确定肺动脉高压患者的最佳麻醉管理可能并不重要，但对于评估长期预后很重要。
