Primary Pulmonary Hypertension and Oral Phentolamine

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To the editor: Ruskin and Hutter (1) have shown that oral phentolamine can prevent an exercise-induced increase in pulmonary artery mean pressure in a patient with primary pulmonary hypertension. Despite only a small decrease in resting pressures, their patient had symptomatic improvement with a marked increase in exercise tolerance. That is an important observation. It suggests that in patients with primary pulmonary hypertension, drugs should be tested at rest and during exercise. Symptomatic improvement has also been shown with sublingual isoproterenol (2) and diazoxide (3) in some patients. The fact that some patients decrease and others increase their pulmonary artery

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