Riociguat as inpatient rescue therapy for acute decompensation of inoperable chronic thromboembolic pulmonary hypertension.
Reema Hamdan Alsufyani, Sharjeel Imran, Brian Mccullagh et al.
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Case in brief
A man in his 70s with a history of asbestos exposure presented with syncope and progressive dyspnoea. Initial imaging revealed bilateral pulmonary emboli and pulmonary hypertension. After outpatient worsening, he was hospitalized with right heart failure symptoms. Despite diuresis and anticoagulation, he required high-flow oxygen. Riociguat was initiated, leading to rapid clinical improvement and reduced oxygen needs within 72 hours. He was diagnosed with inoperable chronic thromboembolic pulmonary hypertension and continued on riociguat as long-term therapy.
Diagnostic / clinical pearl
This case highlights the potential of riociguat as an effective rescue therapy for patients with acute decompensation due to inoperable chronic thromboembolic pulmonary hypertension.