Clinical case: combination therapy with iloprost and sildenafil in the treatment of idiopathic pulmonary hypertension

Abstract

Idiopathic pulmonary arterial hypertension is a rare disease with unknown etiology, characterized by progressive increase in pulmonary vessel resistance, right heart failure. Combined pathogenetic therapy using leads to depression of disease progression, repeated hospitalization, improvement in disease prognosis in patients with III-IV functional class (WHO).The patient with diagnosis of idiopathic pulmonary arterial hypertension, verified by right heart catheterization method, functional class III (WHO) was treated by anticoagulants, diuretics. There were observed the negative dynamic with right heart chambers dilation, appearing of heart failure signs during the treatment with phosphodiesterase type 5-inhibitor sildenafil. After adding an inhaled form of prostanoids-iloprost to sildenafil therapy there was achieved the significant improvement of the functional and hemodynamic status. Reduction in dyspnoea level, improvement in physical activity tolerance and disease prognosis were reached.