Bosentan improved syncope in a hemodialysis patient with pulmonary hypertension and mild aortic stenosis.

Pulmonary arterial hypertension (PAH), caused by collagen diseases, Eisenmenger syndrome or of idiopathic etiology, generally has a poor prognosis. Recently, bosentan, a dual endothelin receptor antagonist, has become available for treating PAH. This report describes a bosentan-effective case of combined PAH, hemodialysis and mild aortic stenosis. A 71-year-old woman on hemodialysis was referred to our hospital because of repetitive syncope. Although neurological examinations revealed no etiological diseases, echocardiography and cardiac catheterization showed PAH and mild aortic valve stenosis. Bosentan abolished syncope with improvement of hemodynamic parameters. This report suggests bosentan was clinically useful in a hemodialysis patient with pulmonary hypertension and mild aortic valve stenosis.