Pulmonary Hypertension

Asthma ◽  
2014 ◽  
pp. 215-228
Author(s):  
Aaron B. Waxman ◽  
Kerri Akaya Smith
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Diseases ◽  
Significant Delay ◽  
Obstructive Lung Diseases ◽  
Poor Outcome ◽  
Common Causes ◽  
Appropriate Therapy ◽  
Pulmonary Arterial

Pulmonary hypertension (PH) is a spectrum of diseases involving the pulmonary vascular circuit and is defined as an elevation in pulmonary arterial pressures. PH is an uncommon disorder that presents with nonspecific complaints. There remains a significant delay in the diagnosis of PH and initiation of appropriate therapy because often patients are misdiagnosed with more common causes of dyspnea such as obstructive lung diseases like asthma. The diagnosis of PH should be considered in patients who do not fit the usual profile of patients presenting with dyspnea and asthma, especially if they do not respond to therapy. The finding of PH foreshadows a poor outcome if not discovered early and treated aggressively.

Pulmonary hypertension: definition

ESC CardioMed ◽  
2018 ◽  
pp. 2482-2484
Author(s):  
Stephan Rosenkranz
Keyword(s):  
Pulmonary Hypertension ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Left Heart ◽  
Chronic Lung Diseases ◽  
Common Causes ◽  
Thromboembolic Pulmonary Hypertension ◽  
Underlying Causes ◽  
Pulmonary Arterial ◽  
Clinical Phenotyping ◽  
Global Population

Pulmonary hypertension (PH) in general is characterized by an elevation of pulmonary artery pressure which may result from various underlying causes. PH is a common disorder affecting approximately 1% of the global population, and up to 10% of patients older than 65 years of age. The most common causes are diseases of the left heart and chronic lung diseases, whereas disorders primarily originating from the pulmonary vessels including pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension remain relatively rare conditions. PH is primarily defined by haemodynamic variables, and subdivided into pre- and post-capillary PH. Further information obtained from imaging, pathology, genetics, and clinical phenotyping may be required for accurate subclassification of PH.

scholarly journals Pulmonary Hypertension: A Common Complication of Left Heart Disease

2011 ◽  
Vol 10 (1) ◽  
pp. 41-45
Author(s):  
Hunter C. Champion
Keyword(s):  
Pulmonary Hypertension ◽  
Left Ventricular ◽  
Left Heart ◽  
Ventricular Assist ◽  
Left Heart Failure ◽  
Pulmonary Capillary ◽  
Left Ventricular Assist ◽  
Common Causes ◽  
Ventricular Support ◽  
Pulmonary Arterial

Pulmonary hypertension (PH) commonly results as a complication of left heart failure (systolic or nonsystolic dysfunction). It is important to note that there is a distinct difference between PH as a whole and pulmonary arterial hypertension (PAH), which have the same criteria with regard to mean pulmonary artery pressure (mPAP) as PAH with the critical difference of the pulmonary capillary wedge pressure (PCWP) measurement. Table 1 shows the most common causes of RV dysfunction. The issue of management of right ventricular (RV) failure has recently become more important with increased awareness of RV failure symptoms in the setting of PH. Moreover, with growing consideration for surgical left ventricular support (left ventricular assist device, LVAD) and the need for RV functional competence, the need to better understand the role of RV function is becoming more paramount.

scholarly journals Pulmonary Hypertension in Parenchymal Lung Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Iraklis Tsangaris ◽  
Georgios Tsaknis ◽  
Anastasia Anthi ◽  
Stylianos E. Orfanos
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Diffuse Parenchymal Lung Diseases ◽  
Pulmonary Arterial ◽  
Parenchymal Lung Disease ◽  
Parenchymal Lung

Idiopathic pulmonary arterial hypertension (IPAH) has been extensively investigated, although it represents a less common form of the pulmonary hypertension (PH) family, as shown by international registries. Interestingly, in types of PH that are encountered in parenchymal lung diseases such as interstitial lung diseases (ILDs), chronic obstructive pulmonary disease (COPD), and many other diffuse parenchymal lung diseases, some of which are very common, the available data is limited. In this paper, we try to browse in the latest available data regarding the occurrence, pathogenesis, and treatment of PH in chronic parenchymal lung diseases.

Pulmonary hypertension due to chronic lung diseases

ESC CardioMed ◽  
2018 ◽  
pp. 2547-2550
Author(s):  
Ari Chaouat ◽  
Anne Guillaumot ◽  
Emmanuel Gomez ◽  
Olivier Huttin ◽  
Christine Selton-Suty ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Lung Diseases ◽  
Heart Diseases ◽  
Severe Pulmonary Hypertension ◽  
Therapeutic Implications ◽  
Chronic Lung Diseases ◽  
Pulmonary Haemodynamics ◽  
Pulmonary Arterial

Mild-to-moderate pulmonary hypertension is a common complication of chronic lung diseases. Very few patients have severe pulmonary hypertension; if that is the case, it may be due to co-morbidities or correspond to a particular phenotype. Although pulmonary hypertension has little or no involvement in exercise limitation, it is an independent prognostic factor for survival. The first stage of diagnosis of pulmonary hypertension in chronic lung disease is to establish a level of high, intermediate, or low probability using Doppler echocardiography according to the European Society of Cardiology/European Respiratory Society Guidelines. To determine the cause of pulmonary hypertension, it may be necessary to perform a comprehensive search for the most frequent respiratory and cardiovascular diseases. There are few, but important, indications for right heart catheterization in chronic lung diseases. The main indications are candidates for lung transplantation, suspicion of pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension, and when pulmonary haemodynamics are likely to have significant therapeutic implications. The underlying respiratory disease or associations of diseases should be treated according to current guidelines before concluding that a patient has severe pulmonary hypertension. Non-invasive ventilation and long-term oxygen therapy in hypercapnic and hypoxaemic patients, respectively, improve pulmonary haemodynamics. With the exception of cardiovascular co-morbidities, pharmacotherapies for high blood pressure and for left heart diseases are not recommended to treat pulmonary hypertension due to chronic lung diseases. Pulmonary arterial hypertension-approved therapies are not recommended in pulmonary hypertension due to chronic lung diseases.

Out of proportion pulmonary hypertension in obstructive lung diseases

2018 ◽  
Vol 24 (2) ◽  
pp. 161-172 ◽  
Author(s):  
Kshitij Chatterjee ◽  
Ahmad R. Tarawneh ◽  
Shoaib Alam
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Diseases ◽  
Obstructive Lung Diseases

scholarly journals THE DIFFICULTIES IN THE DIAGNOSIS OF PULMONARY HYPERTENSION ASSOCIATED WITH CHRONIC LUNG DISEASE

2020 ◽  
Vol 73 (9) ◽  
pp. 1853-1860
Author(s):  
Sylwia Łukasik ◽  
Dariusz Łukasik ◽  
Michał Tomaszewski ◽  
Weronika Topyła ◽  
Agnieszka Wojtowska ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Lung Diseases ◽  
Clinical Symptoms ◽  
Vascular Pathology ◽  
Heart Catheterization ◽  
Chronic Lung Diseases ◽  
Pulmonary Arterial ◽  
Group 3

Introduction: Chronic lung disease (WHO group 3) is the second leading cause of pulmonary hypertension (PH). In turn, the development of PH influences the course of lung disease, worsening the clinical symptoms and prognosis. The aim: To analyse the difficulties in the diagnosis of pulmonary hypertension due to chronic lung disease. Review and Discussion: According to recent literature, PH in the course of lung diseases develops as a result of both “parenchymal” and vascular pathology in patients with a genetic predisposition. Prolonged infection (especially viral) may be an additional promoting factor. Elevation of pulmonary arterial pressure (PAP) is usually moderate and correlates with severity of lung disease. In a small minority, PAP may reach that seen in WHO group 1 pulmonary arterial hypertension (PAH). Conclusions: Echocardiography and right heart catheterization are the principal tools for the diagnosis of PH in chronic lung diseases. Unfortunately, current medications for treating PAH have not shown benefit in controlled trials of group 3 PH, hence their routine use is not recommended. Patients with severe group 3 PH should be considered for referral to expert centres or entry into clinical trials.

Mediators and modulators of pulmonary arterial hypertension

2006 ◽  
Vol 291 (4) ◽  
pp. L547-L558 ◽  
Author(s):  
Sami I. Said
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Left Ventricular ◽  
Ventricular Failure ◽  
Appetite Suppressant ◽  
Common Causes ◽  
Chronic Pulmonary Diseases ◽  
Pulmonary Arterial ◽  
Underlying Diseases

Pulmonary hypertension (PH), defined as a mean pulmonary arterial (PA) pressure of >25 mmHg at rest or >30 mmHg during exercise, is characterized by a progressive and sustained increase in pulmonary vascular resistance that eventually leads to right ventricular failure. Clinically, PH may result from a variety of underlying diseases ( Table 1 and Refs. 50 , 113 , 124 ). Pulmonary arterial hypertension (PAH) may be familial (FPAH) or sporadic (idiopathic, IPAH), formerly known as primary pulmonary hypertension, i.e., for which there is no demonstrable cause. More often, PAH is due to a variety of identifiable diseases including scleroderma and other collagen disorders, liver disease, human immunodeficiency virus, and the intake of appetite-suppressant drugs such as phentermine and fenfluramine ( 72 ). Other, more common, causes of PAH include left ventricular failure (perhaps the most common cause), valvular lesions, chronic pulmonary diseases, sleep-disordered breathing, and prolonged residence at high altitude. This classification, now widely accepted, was first proposed at a meeting in Evian, France, in 1998, and modified in Venice, Italy, in 2003 ( 124 ).

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