JAPANESE CIRCULATION JOURNAL
Online ISSN : 1347-4839
Print ISSN : 0047-1828
ISSN-L : 0047-1828
Case Reports
Primary Pulmonary Hypertension With Central Sleep Apnea
- Sudden Death After Bilevel Positive Airway Pressure Therapy -
Toshiaki ShiomiChristian GuilleminaultRyujiro SasanabeYoshitaka OkiRika HasegawaKazuo OtakeKatsuhisa BannoKengo UsuiMasato MaekawaHitoshi KanayamaRyoutaro TakahashiTadashi Kobayashi
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2000 Volume 64 Issue 9 Pages 723-726

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Abstract

An obese 23-year-old man with sleep-disordered breathing and primary pulmonary hypertension (PPH) had been administered oral beraprost sodium, anticoagulant warfarin, and home oxygen therapy, at another hospital as treatment for the PPH, but he had not experienced any symptomatic improvement. The patient had a body mass index of 32.4 kg/m2, and complained of fatigue, shortness of breath on exertion, excessive daytime sleepiness, and snoring. Arterial blood gas analysis showed a PaO2 and a PaCO2 of 70.9 and 31.2 mmHg, respectively. A polysomnographic study revealed central sleep apnea with an apnea-hypopnea index (AHI) of 29.7 episodes/h. The patient showed improvement of daytime sleepiness after starting nocturnal nasal bilevel positive airway pressure (BiPAP) therapy for the central sleep apnea, but his pulmonary hypertension, measured in the daytime, worsened. The patient died suddenly while walking to the bathroom in the morning 1 month after initiation of BiPAP therapy. It is necessary to consider the possibility of sudden death when nasal BiPAP therapy is given to a PPH patient with central sleep apnea.

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© 2000 THE JAPANESE CIRCULATION SOCIETY
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