Virtual Conference
Heart 2022 Conference

Palega Daniela

State University of Medicine and Pharmacy “Nicolae Testemi?anu, Moldova

Title: Pulmonary arterial hypertension in children- new approaches of diagnosis and management


Pulmonary hypertension (PH) is a pathophysiological condition that includes multiple clinical situations and can complicate most cardiovascular and respiratory diseases. The specific modern treatment with endothelin receptor inhibitors significantly improves the disease’s clinical course and brings better parameters at instrumental investigations. A 6-years-old boy is admitted to the cardiology department with high fatigue, weakness, excessive sweating, and dry caught. Clinical examination revealed growth and development retardation (16 kg (25P), 105 cm (25P), 14.5 kg/m2). The child is born prematurely at 29 weeks with a weight of 2100 grams and a height of 47 cm. After birth, echocardiography shows the presence of patent arterial duct (PAD). At the age of 5 years, CT Angiography shows congenital cardiac malformation - PAD (7 mm in length and 9×7 mm in diameter) with high flow, the aortic and pulmonary connections of the PAD are not obstructive, the pulmonary artery trunk is extremely dilated (19×18 mm), dilatation of right atrium and ventricle with severe PH. At the cardiac catheterization mPAP  70 mm/Hg, PVR- 1.590, systemic vascular resistance – 1.545, PVR/SVR res ratio- 1.03.  The surgery is questionable according to existing data and pharmacological treatment is indicated. The patient is included in a rare disease program in the Republic of Moldova PH and starts his combined treatment with Bosentan and Sildenafil. Before therapy the oxygen saturation hand/ leg- 97/68%, 6MWT- 420 steps, mPAP- 70, RSVP- 70, cardiac index- 3,55. Four months after therapy- the oxygen saturation hand/ leg- 97/80 %, 6MWT- 500 steps, mPAP- 43, RSVP- 70, cardiac index- 2,64.

Conclusion: This case demonstrates the severe and progressive course of PH, with rapid invalidation and a considerable decrease in life quality. On the other hand, modern pharmacological approaches with specific and combined therapy –Bosentan with Sildenafil, reveal new perspectives of an effective treatment and considerably improve the prognosis.


Palega Daniela is a resident doctor at Pediatrics Department of State University of Medicine and Pharmacy” Nicolae Testemi?anu”. Also, she is a phD student, the main scientific interest is Pulmonary Hypertension in children with congenital heart shunts. Her mentor is  Palii Ina- Doctor Habilitatus in Medicine, Professor, Chief of the Paediatric Department & Paediatric Cardiology Clinic Research Institute Mother and Child Health Care.