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The Journal of the Royal Society for the Promotion of Health
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Lessons to be learned: a case study approach A case study of the temporal onset of pulmonary hypertension with pre-existent cirrhotic portal hypertension

R. D'Souza

Medical Unit, Highland Acute Hospitals NHS Trust, Inverness IV2 3UJ, Scotland

R.J. MacFadyen

Cardiac Unit, Highland Acute Hospitals NHS Trust, Inverness IV2 3UJ, Scotland

F. Kerr

Cardiac Unit, Highland Acute Hospitals NHS Trust, Inverness IV2 3UJ, Scotland

A. Peacock

Scottish Pulmonary Vascular Unit, Western Infirmary, Glasgow G11 6NT, Scotland

M.M. Steven

Medical Unit, Highland Acute Hospitals NHS Trust, Inverness IV2 3UJ, Scotland

We report the occurrence of pulmonary hypertension in a 37-year-old male patient with cirrhosis of the liver, portal hyperten sion and oesophageal varices. Although this is a rare combination, previous reports have shown that the association of portal and pulmonary hypertension is not coinci dental; the temporal onset of primary pul monary hypertension is hard to predict and our patient was asymptomatic for a number of years. The pathogenesis of portal hypertension leading to pulmonary hyper tension is not known. Diagnosis is difficult because the clinico-pathological symptoms in both conditions are similar. Treatment is limited to calcium channel blockers, vasodilators, nitrous oxide and prostacyclin, although most patients will eventually require visceral transplantation.

Key Words: Echocardiography • endothelin receptor antagonism • liver cirrhosis • pulmonary hypertension • temporal disease pattern

The Journal of the Royal Society for the Promotion of Health, Vol. 121, No. 4, 257-261 (2001)
DOI: 10.1177/146642400112100410
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