Zhang Yu, Yan Yue, Xie Wanmu, Zhai Zhenguo, Huang Qiang
National Center for Respiratory Medicine Beijing China.
State Key Laboratory of Respiratory Health and Multimorbidity Beijing China.
Pulm Circ. 2024 Dec 18;14(4):e70030. doi: 10.1002/pul2.70030. eCollection 2024 Oct.
Balloon pulmonary angioplasty (BPA) is now a widely accepted treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH), but it still faces the problem of high complications. Herein, we report a rare case of severe vagal response during the BPA of a total occlusion lesion in a patient with CTEPH. The patient experienced acute chest pain and dyspnea, accompanied by a significant decrease in heart rate and blood pressure. After administering atropine, the patient's symptoms rapidly subsided. This case highlights the potential for vascular and pleural injury with chest pain, which can lead to severe vagal response during the BPA procedures. To minimize this risk, avoiding guide wire-induced injury to the pleura situated distal to the target vessel is crucial.
球囊肺动脉血管成形术（BPA）目前是治疗无法手术的慢性血栓栓塞性肺动脉高压（CTEPH）的一种广泛接受的方法，但它仍然面临高并发症的问题。在此，我们报告一例CTEPH患者在BPA治疗完全闭塞病变过程中发生严重迷走神经反应的罕见病例。该患者出现急性胸痛和呼吸困难，伴有心率和血压显著下降。给予阿托品后，患者症状迅速缓解。该病例突出了血管和胸膜损伤伴胸痛的可能性，这可能导致BPA手术过程中出现严重迷走神经反应。为了将这种风险降至最低，避免导丝对靶血管远端胸膜造成损伤至关重要。
