What does coughing black blood and a very high oxygen level in a 23-year-old patient with VSD indicate?

Question

Hello doctor,

My sister has had a ventricular septal defect since birth. She is 23 years old now. There are not many symptoms being shown except tachypnea on working hard, walking to some distance, and going upstairs. In the last three months, her cough has shown some blackish blood, and her recent report shows a hemoglobin level of 18 g/dL. Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your sister's reports (the attachments have been removed to protect the patient's identity). Unfortunately, her VSD (ventricular septal defect) is at a point where closure is not possible due to high pressures on the right side of the heart. The high hemoglobin level and the symptoms of coughing black blood are due to this. I suggest you go ahead with phlebotomy as suggested by the cardiologist and also explore the possibility of giving Sildenafil or Bosentan to bring down her pulmonary artery pressures.

What does coughing black blood and a very high oxygen level in a 23-year-old patient with VSD indicate?

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