Unusual clinical course, Challenging differential diagnosis, Unusual setting of medical care
Marcel M. Letourneau, Daniel Brancheau, Jessica Estes, Marcel Zughaib
Department of Cardiovascular Medicine, Ascension Providence Hospital, Southfield, MI, USA
Am J Case Rep 2020; 21:e922857
Available online: 2020-08-17
The heart failure patient population can be challenging to treat and monitor. This is especially true when they travel to high altitudes where changes in pressure can affect their clinical status. The CardioMEMS™ HF System (Abbott Cardiovascular, Abbott Park, IL, USA) is an implanted miniature wireless device located in the pulmonary artery that transmits data on pulmonary artery pressure and heart rate. This data can be used to detect this dramatic invasive pressure change.
CASE REPORT: We present the case of a 78-year-old man with an exacerbation of heart failure while traveling to high altitude. Elevation of his pulmonary artery (PA) pressures were detected by his implanted CardioMEMS device. Understanding the expected change in PA pressure recordings helped to identify a true exacerbation of heart failure in our patient. This led to a prompt change in medical therapy, which ultimately prevented hospitalization.
CONCLUSIONS: Increased elevation can lead to falsely elevated PA pressure readings by the CardioMEMS device. However, we present the case of a patient with a disproportionate elevation of his hemodynamic pressure measurements, indicating an exacerbation of heart failure. This case demonstrates the value of the CardioMEMS device in detecting PA pressure changes in these unique circumstances.
Keywords: arterial pressure, Atmospheric Pressure, Blood Pressure Monitors, Heart Failure, Pulmonary Artery