Table 1 Timeline – history, course of the disease, diagnosis and treatment
1976 | right-hand pneumothorax |
2007 | Hospitalized three times for atrial fibrillation and heart failure echocardiography, cardioversion, coronarography were performed. Every time discharged from the departments with diagnosis: Atrial fibrillation, Heart failure, NYHA class II. |
2010–2011 | Increasing growing shortness of breath and symptoms of heart failure. Patient was hospitalized 3 times. Indirect features of pulmonary hypertension in echocardiography were detected. Three times chest-CT examination was performed; pulmonary embolism or chronic thromboembolic pulmonary arterial hypertension (2 x angio-CT) or pulmonary fibrosis (high resolution computer tomography) was excluded. Diagnosis of pulmonary hypertension was established, WHO class III. |
DEC-2011 | Admission to cardiology clinic – echocardiography (TTE, TEE), 6-min walking test, NT-proBNP, right heart catheterisation, pulmonary vasoreactivity test. Diagnosis of irreversible arterial pulmonary hypertension was established. Treatment with the illoprost and sildenafil has started |
JAN-2012 | control visit – improvement in WHO class, decrease of NT-proBNP concentration and increase of 6-min test distance |
MAY-2012 | Control RHC. SaO2 of blood samples obtained during RHC from upper lobe artery of the right lung amounted 87%. Angiographic diagnostic of pulmonary arteries revealed PAH fistulas between subclavian and upper lobe of right lung arteries |
JUN 2012 | angio-CT of systemic arteries revealed additional presence of bronchial artery fistulas to upper lobe of right lung arteries |
III-2013 | Embolisation of fistulas |
VI-2013 | Death as a result of worsening of heart failure combined with pneumonia. |