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Under standard American Society of Anesthesiologists (ASA) monitoring, invasive blood pressure monitoring and continuous transthoracic echocardiography, the patient\u2019s right ventricular systolic function was monitored throughout the case using qualitative and quantitative metrics and was notable for a right ventricular systolic pressure of 102.4\u2009mm Hg. Milrinone, started prior to epidural titration, was used for inotropic support. Vasopressin was used in conjunction to sustain systemic vascular resistance while having little effect on the pulmonary vascular resistance. The patient experienced no complications or exacerbation of her pulmonary hypertension and was discharged home the following day.<\/jats:p>","DOI":"10.1136\/bcr-2023-257225","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T12:53:37Z","timestamp":1707224017000},"page":"e257225","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Anaesthetic management of a patient with severe pulmonary hypertension, moderate tricuspid regurgitation and moderate right ventricular dysfunction presenting for a dilation and curettage"],"prefix":"10.1136","volume":"17","author":[{"given":"Joshua","family":"Anderson","sequence":"first","affiliation":[{"name":"Anesthesiology, University of Louisville School of Medicine, Louisville, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9654-6985","authenticated-orcid":false,"given":"Ryan","family":"Grell","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of Louisville School of Medicine, Louisville, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Haines","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of Louisville School of Medicine, Louisville, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,2,6]]},"reference":[{"key":"2025082712021914000_17.2.e257225.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000458"},{"key":"2025082712021914000_17.2.e257225.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1183\/13993003.01913-2018","article-title":"Haemodynamic definitions and updated clinical classification of pulmonary hypertension","volume":"53","author":"Simonneau","year":"2019","journal-title":"Eur Respir J"},{"key":"2025082712021914000_17.2.e257225.3","unstructured":"Pulmonary Hypertension Association . 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