PT  - JOURNAL ARTICLE
AU  - Kyle Masters
AU  - Steven Bennett
TI  - Pulmonary veno-occlusive disease: an uncommon cause of pulmonary hypertension
AID  - 10.1136/bcr-2012-007752
DP  - 2013 Feb 01
TA  - BMJ Case Reports
PG  - bcr2012007752
VI  - 2013
4099  - http://casereports.bmj.com/content/2013/bcr-2012-007752.short
4100  - http://casereports.bmj.com/content/2013/bcr-2012-007752.full
AB  - Pulmonary veno-occlusive disease (PVOD) is a rare and challenging cause of pulmonary hypertension. Clinical presentation is non-specific, including dyspnoea, cough and fatigue. Diagnosis of PVOD is typically based on high clinical suspicion with a definitive diagnosis confirmed by histology. Our case involves a healthy 21-year-old man who developed dyspnoea on exertion at an elevated altitude during deployment to Afghanistan. His work-up included an echocardiogram, a high-resolution CT scan, V/Q scan, pulmonary function tests with diffusion capacity, and a cardiac catheterisation with vasodilator challenge. Initially diagnosed with vasodilator responsive pulmonary arterial hypertension, an oral vasodilator was given with subsequent development of non-cardiogenic pulmonary oedema, thus confirming a clinical diagnosis of PVOD. He was medically stabilised with diuretic therapy, but developed progressive right-ventricular failure. For definitive treatment, he underwent a successful bilateral lung transplant. Explanted lung histology confirmed the diagnosis of PVOD.