scholarly journals Pulmonary hypertension: From an orphan disease to a global epidemic

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
Ghazwan Butrous
Keyword(s):  
Pulmonary Hypertension ◽  
Vascular Resistance ◽  
Progressive Disease ◽  
Right Ventricular Failure ◽  
Medical Community ◽  
Pulmonary Vasculature ◽  
Current Interest ◽  
Ventricular Failure ◽  
Global Epidemic ◽  
Chronic Progressive Disease

[No abstract. Showing first paragraph of article]Pulmonary hypertension is a progressive disease characterized by an elevation of pulmonary artery pressure and pulmonary vascular resistance, leading to right ventricular failure and death. It remains a challenging chronic progressive disease, but the current interest and advent of medical therapy in the last 20 years has significantly changed the perception of medical community in this disease. Pulmonary hypertension is not a specific disease; the majority of cases present with other diseases and various pathological processes that affect the pulmonary vasculature, and consequently increase pulmonary pressure and vascular resistance.

scholarly journals Diagnosis and treatment of pulmonary hypertension: from the point of view of 2017

2017 ◽  
Vol 89 (12) ◽  
pp. 127-132
Author(s):  
A Sh Sarybaev ◽  
A S Sydykov ◽  
M A Sartmyrzaeva ◽  
A T Mamazhakypov ◽  
A M Maripov ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Premature Death ◽  
Right Ventricular Failure ◽  
Point Of View ◽  
Diagnosis And Treatment ◽  
Ventricular Failure ◽  
New Guidelines

Pulmonary hypertension (PH) is a group of diseases characterized by increased pulmonary vascular resistance (PVR). Regardless of its cause, PH leads to right ventricular failure and premature death. Recent advances in the diagnosis and treatment of PH have prompted the elaboration of new guidelines for the diagnosis and treatment of PH. This paper provides a brief overview of major achievements in diagnostic and treatment approaches in patients PH.

scholarly journals Supra-systemic pulmonary hypertension after complicated percutaneous mitral balloon valvuloplasty: a case report and review of literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jose R. Navas-Blanco ◽  
Justin Miranda ◽  
Victor Gonzalez ◽  
Asif Mohammed ◽  
Oscar D. Aljure
Keyword(s):  
Pulmonary Hypertension ◽  
Case Report ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Tissue Perfusion ◽  
Venous Hypertension ◽  
Right Ventricular Failure ◽  
Balloon Valvuloplasty ◽  
Ventricular Failure ◽  
The Moment

Abstract Background The World Symposium of Pulmonary Hypertension in 2018, updated the definition of pulmonary hypertension (PH) as mean pulmonary artery pressures (PAP) > 20 mmHg. Pulmonary venous hypertension secondary to left-heart disease, constitutes the most common cause of PH, and the determination of a co-existent pre-capillary (primary) PH becomes paramount, particularly at the moment of evaluating and managing patients with heart failure. Pulmonary artery pressures above the systemic pressures define supra-systemic PH and generally leads to frank right ventricular failure and high mortality. Case presentation We present the perioperative management of a patient with rheumatic mitral valve disease, initially found to have severe PH due to pulmonary venous hypertension, who underwent percutaneous mitral balloon valvuloplasty complicated with mitral chordae rupture, severe mitral regurgitation and supra-systemic PH. Multiple medical therapies and an intra-aortic balloon pump were used as means of non-surgical management of this complication. Conclusions This case report illustrates the perioperative implications of combined pre- and post-capillary PH and supra-systemic PH, as this has not been widely discussed in previous literature. A thorough literature review of the clinical characteristics of PH, methods to determine co-existent pre- and post-capillary PH components, as well as concomitant right ventricular failure is presented. Severe PH has known detrimental effects on the hemodynamic status of patients, which can ultimately lead to a decrease in effective cardiac output and poor tissue perfusion.

scholarly journals Pulmonary Hypertension in Pregnancy: Critical Care Management

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Adel M. Bassily-Marcus ◽  
Carol Yuan ◽  
John Oropello ◽  
Anthony Manasia ◽  
Roopa Kohli-Seth ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Critical Care ◽  
Right Ventricular ◽  
Pregnant Women ◽  
Signs And Symptoms ◽  
Right Ventricular Failure ◽  
Team Approach ◽  
Ventricular Failure ◽  
Critical Care Management ◽  
New Treatments

Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30–56%. In the past decade, new treatments for pulmonary hypertension have emerged. Their application in pregnant women with pulmonary hypertension may hold promise in reducing morbidity and mortality. Signs and symptoms of pulmonary hypertension are nonspecific in pregnant women. Imaging workup may have undesirable radiation exposure. Pulmonary artery catheter remains the gold standard for diagnosing pulmonary hypertension, although its use in the intensive care unit for other conditions has slowly fallen out of favor. Goal-directed bedside echocardiogram and lung ultrasonography provide attractive alternatives. Basic principles of managing pulmonary hypertension with right ventricular failure are maintaining right ventricular function and reducing pulmonary vascular resistance. Fluid resuscitation and various vasopressors are used with caution. Pulmonary-hypertension-targeted therapies have been utilized in pregnant women with understanding of their safety profile. Mainstay therapy for pulmonary embolism is anticoagulation, and the treatment for amniotic fluid embolism remains supportive care. Multidisciplinary team approach is crucial to achieving successful outcomes in these difficult cases.

Mechanisms of hypotension produced by platelet-activating factor

1989 ◽  
Vol 66 (6) ◽  
pp. 2681-2690 ◽  
Author(s):  
F. R. Laurindo ◽  
R. E. Goldstein ◽  
N. J. Davenport ◽  
D. Ezra ◽  
G. Z. Feuerstein
Keyword(s):  
Right Ventricular ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Ventricular Dysfunction ◽  
Platelet Activating Factor ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Right Ventricular Failure ◽  
Right Atrial ◽  
Ventricular Failure

Platelet-activating factor (PAF) is a phospholipid mediator that induces cardiovascular collapse and release of the secondary mediator thromboxane A2 (TxA2). To clarify mechanisms involved in this collapse and, specifically, the relative contribution of left ventricular and right ventricular dysfunction, we studied 12 open-chest pigs. PAF infusion (0.04–0.28 nmol.kg-1.min-1) induced a 5- to 120-fold increase in pulmonary vascular resistance, a 75–98% fall in cardiac output, and systemic arterial hypotension. Right ventricular failure was indicated by chamber enlargement, decreased shortening, and increased right atrial pressures. In contrast, left ventricular dysfunction was accompanied by decreases in chamber dimensions and filling pressures that were unresponsive to volume expansion. U 46619 (a stable TxA2 analogue) and mechanical pulmonary artery constriction induced changes similar to PAF. In 11 additional closed-chest pigs, TxA2 blockade with indomethacin attenuated the PAF-induced rise in pulmonary vascular resistance, right ventricular dysfunction, and systemic hypotension. A specific TxA2 synthase inhibitor, OKY-046, also diminished hemodynamic effects of PAF in six other pigs. Tachyphylaxis was not observed in five pigs repeatedly given PAF. We conclude that acute right ventricular failure as the result of severe increase in pulmonary vascular resistance is the primary mechanism early in the course of PAF-induced shock in the pig. PAF-induced release of TxA2 may contribute significantly to these events.

Sign in / Sign up

Export Citation Format

Share Document