Archives of the Turkish Society of Cardiology
Diverse echocardiographic changes in the course of hypoxia due to acute exacerbation of idiopathic pulmonary fibrosis [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2020; 48(6): 619-622 | DOI: 10.5543/tkda.2020.30464

Diverse echocardiographic changes in the course of hypoxia due to acute exacerbation of idiopathic pulmonary fibrosis

Toshimitsu Tsugu1, Yuji Nagatomo2, Hidefumi Koh3, Kaoru Tanaka4, Patrizio Lancellotti1
1Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Giga Cardiovascular Sciences, Liège, Belgium
2Department of Cardiology, National Defense Medical College Hospital, Tokorozawa, Japan
3Division of Pulmonary Medicine, Federation of National Public Service Personnel Mutual Aid Association Tachikawa Hospital, Tachikawa, Japan
4Department of Radiology, Universitair Ziekenhuis Brussels, Belgium

Idiopathic pulmonary fibrosis (IPF) is a progressive parenchymal disease. Pulmonary hypertension (PH) is a potentially lethal complication in the course of IPF. In almost all cases of IPF-PH there is gradual deterioration, but patients can also decline suddenly due to hypoxia. This case report describes the different echocardiographic changes observed in 2 episodes of hypoxic attack in a 73-year-old man. On admission, the tricuspid regurgitation peak gradient (TRPG) was 21 mmHg and the oxygen saturation rate was 94% (O2: 4 L/min). Five days after admission, the TRPG and oxygen saturation rate deteriorated [TRPG: 85 mmHg, oxygen saturation: 72% (O2; 4 L/min)]. He was diagnosed with IPF-PH due to hypoxic pulmonary vasoconstriction. Oxygen therapy and methylprednisolone pulse therapy (MPT) were administered. Five days after the MPT treatment, the hypoxia and PH improved [TRPG: 21 mmHg, oxygen saturation: 95% (O2: 4 L/min)]. Acute exacerbation of IPF (IPF-AE) occurred 20 days after the MPT, and a second dose of MPT was administered. The TRPG and oxygen saturation rate did not decline [TRPG: 27 mmHg, oxygen saturation: 94% (O2: 4 L/min)]. The patient died 10 days after the second dose of MPT. Divergent echocardiographic findings were observed during the deterioration of IPF-AE in the presence of IPF-PH.

Keywords: Acute exacerbation, idiopathic pulmonary fibrosis; pulmonary hypertension; right heart failure.

How to cite this article
Toshimitsu Tsugu, Yuji Nagatomo, Hidefumi Koh, Kaoru Tanaka, Patrizio Lancellotti. Diverse echocardiographic changes in the course of hypoxia due to acute exacerbation of idiopathic pulmonary fibrosis. Turk Kardiyol Dern Ars. 2020; 48(6): 619-622

Corresponding Author: Toshimitsu Tsugu, Belgium
© Copyright 2020 Archives of the Turkish Society of Cardiology
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