Authors
Xiaofeng Su, Chao Yu, Jian Liu
Published in
BMC cardiovascular disorders. Jul 17, 2026. Epub Jul 17, 2026.
Abstract
Complete heart block (CHB) is commonly encountered in older adults, yet its hemodynamic consequences extend beyond bradycardia and reduced cardiac output. Severe pulmonary hypertension (PH) secondary to atrioventricular (AV) dyssynchrony is exceedingly rare, particularly in patients with preserved left ventricular systolic function. Recognizing reversible PH due to rhythm disturbances is essential in the geriatric population where symptoms are often nonspecific.
An 86-year-old man presented with progressive fatigue, orthopnea, and presyncope. Echocardiography revealed severe PH with an estimated pulmonary artery systolic pressure (PASP) of 120 mmHg, preserved left ventricular ejection fraction (LVEF) of 60%, marked left atrial dilation, right ventricular enlargement, and moderate diastolic tricuspid regurgitation (TR). A dual-chamber pacemaker was implanted urgently, resulting in a rapid decline in PASP to 75 mmHg within 24 h, with a further decrease to 40 mmHg by two weeks. Structural cardiac improvements were sustained at one-year follow-up.
This case highlights a rare and potentially reversible form of PH possibly triggered by AV dyssynchrony in an older adult with CHB. Diastolic TR may serve as a diagnostic clue, and restoration of AV synchrony was associated with rapid improvement in pulmonary pressures. These findings highlight the importance of considering arrhythmia-related reversible PH in elderly patients with cardiopulmonary symptoms and preserved systolic function.
PMID:
42469613
Bibliographic data and abstract were imported from PubMed on 18 Jul 2026.
Read full publication at:
Please sign in
to see all details.
Advertisement
Stats
- Recommendations n/a n/a positive of 0 vote(s)
- Views 4
- Comments 0