Diagnosis and management of pulmonary arterial hypertension
- PMID: 21941650
- PMCID: PMC3176617
- DOI: 10.1155/2011/845864
Diagnosis and management of pulmonary arterial hypertension
Abstract
Pulmonary arterial hypertension is a rare disease, which requires a high index of suspicion to diagnose when patients initially present. Initial symptoms can be nonspecific and include complaints such as fatigue and mild dyspnea. Once the disease is suspected, echocardiography is used to estimate the pulmonary arterial (PA) pressure and to exclude secondary causes of elevated PA pressures such as left heart disease. Right heart catheterization with vasodilator challenge is critical to the proper assessment of pulmonary hemodynamics and to determine whether patients are likely to benefit from vasodilator therapy. Pathologically, the disease is characterized by deleterious remodeling of the distal pulmonary arterial and arteriolar circulation, which results in increased pulmonary vascular resistance. In the last fifteen years, medications from three different classes have been approved for the treatment of pulmonary arterial hypertension. These include the prostanoids, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors.
Figures
References
-
- Tuder RM, Abman SH, Braun T, et al. Development and pathology of pulmonary hypertension. Journal of the American College of Cardiology. 2009;54(1) supplement 1:S3–S9. - PubMed
-
- D’Alonzo GE, Barst RJ, Ayres SM, et al. Survival in patients with primary pulmonary hypertension: results from a national prospective registry. Annals of Internal Medicine. 1991;115(5):343–349. - PubMed
-
- Lane KB, Machado RD, Pauciulo MW, et al. Heterozygous germline mutations in BMPR2, encoding a TGF-β receptor, cause familial primary pulmonary hypertension. The International PPH consortium. Nature Genetics. 2000;26(1):81–84. - PubMed
-
- Christman BW, McPherson CD, Newman JH, et al. An imbalance between the excretion of thromboxane and prostacyclin metabolites in pulmonary hypertension. The New England Journal of Medicine. 1992;327(2):70–75. - PubMed
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
