Contemporary diagnosis and management of pulmonary hypertension

Introduction and classification Pulmonary hypertension (PH) encompasses a group of diseases associated with an elevated mean pulmonary artery pressure (mPAP) ≥25 mm Hg at rest. The symptoms of PH are non-specific, and it should be suspected in any patient with unexplained exertional dyspnoea, exertional dizziness (near syncope), syncopal episodes and/or signs of right ventricular dysfunction. PH can predominantly affect the precapillary part of the pulmonary circulation, for example, pulmonary arterial hypertension (PAH) or postcapillary—pulmonary venous circulation due to left heart disease (PH-LHD). A pulmonary artery wedge pressure (PAWP) or left ventricular end diastolic pressure (LVEDP) ≤15 mm Hg differentiates precapillary from postcapillary PH. The causes of PH are classified into five major groups based on similarities in pathophysiological mechanisms, clinical presentation and therapeutic options: Group 1 PAH, which can be idiopathic (IPAH), heritable (HPAH), drug-induced and toxin-induced or associated with other medical conditions, for example, systemic sclerosis, portal hypertension, congenital heart disease...
Source: Heart - Category: Cardiology Authors: Tags: Education in Heart, Congenital heart disease, Drugs: cardiovascular system, Hypertension, Epidemiology, Metabolic disorders Source Type: research