Prostaglandin E1 in pulmonary hypertension of collagen disease

A 47-yr-old woman with low cardiac output and dyspnea due to pulmonary hypertension associated with rheumatoid arthritis was treated with two vasodilators. Although nicardipine, a Ca-channel blocking agent, reduced the pulmonary artery pressure (PAP), it reduced simultaneously the arterial BP, resulting in fluid retention with a low urine output and persistent high CVP. In contrast, prostaglandin E1 (PGE1) reduced successfully both the PAP and CVP. Although the BP decreased, a satisfactory urine output was maintained. The cardiac output increased from 3 to 4.5 L/min. PGE1 may help reduce reversible pulmonary hypertension of collagen disease.