[A case of pulmonary thromboembolism with pulmonary hypertension with marked improvement by oral PGI2 analogue].

The patient was a 71-year-old man with dyspnea and bilateral leg edema. He was admitted to our hospital with worsening of dyspnea and had received therapy for chronic heart failure in another hospital. On admission, chest X-ray film revealed dilatation of the cardiac silhouette (CTR: 58%). Electrocardiogram showed atrial fibrillation and negative T wave in II, III, and aVF. Cardiac arteriogram showed no organic lesions, but pulmonary hypertension, pulmonary artery pressure of 60/21/34 mmHg, right ventricular pressure of 40/9/20 mmHg were recognized in pulmonary hemodynamics. The diagnosis of chronic pulmonary thromboembolism was made on the basis of pulmonary arteriogram findings and multiple defects of lung perfusion scintigram. After administration of oral PGI2 analogue for one month, lung perfusion scintigram and right cardiac pressure were markedly improved.