Cardiology>>>>>Pulmonary Hypertension And Pericardium
Question 6#

You are managing a patient admitted with worsening heart failure symptoms. She has been diagnosed with idiopathic pulmonary arterial hypertension and receives continuous IV epoprostenol.

Which one of the following is true?

a. An interruption to the infusion can be tolerated for hours
b. Redness around the line infusion site is expected
c. Treatment with this agent would have been started when the patient was in NYHA class III or IV
d. This treatment will not be used in combination with other advanced therapies
e. Ramipril should be considered if the patient is not already on it

Correct Answer is C


IV epoprostenol addresses the altered prostacylin pathway in pulmonary arterial hypertension. It is the only therapy in which mortality benefit has been demonstrated using a randomized controlled trial. It is indicated when patients are in WHO-FC III and are deteriorating or are in WHO-FC IV, and is often used in combination with other therapies. Specialist nursing input is required. The infusion should never be interrupted and pain/ redness around the line entry site suggests infection which requires immediate attention. Spironolactone is an important diuretic for those in overt right heart failure.