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Correspondence
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Volume 329:812-813 September 9, 1993 Number 11
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Death in a Patient with Primary Pulmonary Hypertension after 20 mg of Nifedipine

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To the Editor: A favorable long-term effect of large doses of nifedipine or diltiazem has been reported in patients with primary pulmonary hypertension when the therapy was guided by invasive testing1. We had an unfortunate experience after such testing.

A 17-year-old previously healthy woman had dyspnea and fatigue for nine months. A diagnosis of primary pulmonary hypertension with right heart failure was made. The pulmonary-artery pressure was 95/52 mm Hg, the wedge pressure 17 mm Hg, and the cardiac output 1.8 liters per minute. Therapy consisted of warfarin, furosemide, and spironolactone. Single-lung transplantation was considered necessary.

Three weeks later, . . . [Full Text of this Article]

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