Pulmonary hypertension and asthma in two patients with congenital heart disease
A. Rothman and T. J. Kulik
Department of Cardiology, Children's Hospital, Harvard Medical School, Boston, Mass.
Reactive airway disease has only rarely been associated with pulmonary
hypertension. We treated two patients with congenital heart disease and
asthma who had increased pulmonary arterial pressure at cardiac
catheterization. Pulmonary hypertension could not be explained solely by
the cardiac lesion, nor by respiratory mechanical factors, as the patients
did not have wheezing during the catheterization study. After long-term
treatment with bronchodilators, corticosteroids, and oxygen, and coincident
with improvement in the airway disease, there was catheterization-proved
diminution of pulmonary hypertension. Whether asthma and pulmonary
hypertension were causally linked is unknown, but further work seems
indicated to elucidate the relationship between bronchoconstriction and
pulmonary vasoconstriction. Furthermore, aggressive management of even mild
reactive airway disease may be warranted in patients with pulmonary
hypertension, regardless of apparent cause.
