Clinical update on pulmonary hypertension

Abstract

Pulmonary hypertension (PH) is a chronic, complex and challenging disease. Advances in treatment are for the subset of patients with pulmonary arterial hypertension. Selected review of the literature was conducted incorporating the European Society of Cardiology/European Respiratory Society 2015 guidelines and recommendations from the Sixth World Symposium on Pulmonary Hypertension. PH is classified into five groups based on WHO classification. Echocardiography remains the initial test of choice, and careful assessment of the right system aids in the diagnosis and prognosis of the disease. Right heart catheterization remains the gold standard of diagnosis and key guidance of treatment. Multidisciplinary approach is recommended for the care of patients with PH. Treatment selection is based on individual risk stratification of patients, and early referral to specialized PH centers improves outcomes of patients. Treating PH is complex and is best carried out in PH centers and with multidisciplinary approach. Early diagnosis and referral to those centers are key not to delay treatment.

Keywords: hypertension, pulmonary; phosphodiesterase 5 inhibitors.

Figure 1

ECHO probability score diagnostic algorithm

Figure 2

RHC, right heart catheterization; CCB, calcium channel blockers; NYHA, New York Heart Association; ERA, endothelin receptor antagonists; PDE5, phosphodiesterase type 5 inhibitor.