Med. praxi. 2013;10(10):318-320

Whom and how to treat for pulmonary hypertension

doc.MUDr.Pavel Jansa, Ph.D.

II. interní klinika kardiologie a angiologie, Centrum pro plicní hypertenzi, Praha

Všeobecná fakultní nemocnice a 1. lékařská fakulta UK, Praha

Pulmonary hypertension encompasses conditions in which mean pulmonary artery pressure exceeds 25 mm Hg. It most commonly occurs

in heart and lung diseases. More rarely, pulmonary hypertension is a result of primary involvement of the pulmonary vessels (particularly

pulmonary arterial hypertension with involvement of the pulmonary arterioles and chronic thromboembolic pulmonary hypertension

associated with inadequate reperfusion following acute pulmonary embolism). It is the treatment of the underlying heart disease that

is crucial in the management of pulmonary hypertension in heart diseases. Specific vasodilation therapy is not indicated in pulmonary

hypertension in heart and lung diseases. Pulmonary endarterectomy is the treatment of choice for chronic thromboembolic pulmonary

hypertension in patients with a surgically accessible thrombotic obstruction. Pharmacotherapy is the mainstay of treatment for pulmonary

arterial hypertension. Treatment with high doses of calcium channel blockers is indicated in patients with a positive vasodilation

test. In the case of a negative test, treatment with prostanoids, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors is

indicated in addition to chronic anticoagulant therapy.

Keywords: pulmonary hypertension, pharmacotherapy, pulmonary endarterectomy

Published: November 7, 2013  Show citation