Korean J Med.  2016 Jun;90(6):528-532. 10.3904/kjm.2016.90.6.528.

Reversible Pulmonary Hypertension due to Sick Sinus Syndrome

• Park JW
• Uhm JS
• Kim DJ
• Park DH
• Kim K
• Cho H
• Chang HJ

• KMID: 2218776
• DOI: http://doi.org/10.3904/kjm.2016.90.6.528

Abstract

A 60-year-old man visited the hospital after experiencing dyspnea after exertion for 2 weeks. An electrocardiogram showed sinus arrest with junctional escape rhythm at 40 beats/min. Transthoracic echocardiography showed that the right ventricular systolic pressure (RVSP) was approximately 71 mmHg and that the left ventricular ejection fraction was preserved. The ratio of peak early diastolic transmitral inflow velocity to early diastolic peak mitral annular velocity (E/E') was 29. Cardiac catheterization revealed a systolic pulmonary artery pressure (SPAP) of 63 mmHg, a mean pulmonary artery pressure of 27 mmHg, and a pulmonary capillary wedge pressure of 22 mmHg with a rhythm of 40 beats/min. The patient was diagnosed with pulmonary hypertension (group 2) due to sick sinus syndrome. SPAP decreased to 48 mmHg during atrial pacing at 60 beats/min. After permanent pacemaker insertion, RVSP decreased from 71 mmHg to 44 mmHg. In this case, passive group 2 pulmonary hypertension occurred due to sick sinus syndrome.

Keyword

Hypertension, Pulmonary; Sick sinus syndrome; Cardiac catheterization

MeSH Terms

Blood Pressure
Cardiac Catheterization
Cardiac Catheters
Dyspnea
Echocardiography
Electrocardiography
Humans
Hypertension, Pulmonary*
Middle Aged
Pulmonary Artery
Pulmonary Wedge Pressure
Sick Sinus Syndrome*
Stroke Volume
United Nations