Management of pulmonary arterial hypertension

Vallerie V. McLaughlin*, Sanjiv J. Shah, Rogerio Souza, Marc Humbert

*Corresponding author for this work

Research output: Contribution to journalReview article

189 Scopus citations

Abstract

Pulmonary hypertension (PH) is common and may result from a number of disorders, including left heart disease, lung disease, and chronic thromboembolic disease. Pulmonary arterial hypertension (PAH) is an uncommon disease characterized by progressive remodeling of the distal pulmonary arteries, resulting in elevated pulmonary vascular resistance and, eventually, in right ventricular failure. Over the past decades, knowledge of the basic pathobiology of PAH and its natural history, prognostic indicators, and therapeutic options has exploded. A thorough evaluation of a patient is critical to correctly characterize the PH. Cardiac studies, including echocardiography and right heart catheterization, are key elements in the assessment. Given the multitude of treatment options currently available for PAH, assessment of risk and response to therapy is critical in long-term management. This review also underscores unique situations, including perioperative management, intensive care unit management, and pregnancy, and highlights the importance of collaborative care of the PAH patient through a multidisciplinary approach.

Original languageEnglish (US)
Pages (from-to)1976-1997
Number of pages22
JournalJournal of the American College of Cardiology
Volume65
Issue number18
DOIs
StatePublished - May 12 2015

Keywords

  • echocardiography
  • endothelin receptor antagonists
  • hemodynamics
  • phosphodiesterase type 5 inhibitors
  • prostacyclins
  • pulmonary arterial hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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