Pulmonary hypertension

Pulmonary hypertension
Other namesPulmonary arterial hypertension,[1] Ayerza syndrome[2]
Pulmonary hypertension
SpecialtyPulmonology, cardiology
SymptomsChest pain, fatigue[3]
Usual onset20 to 60 years old[4]
DurationLong term[1]
CausesUnknown[1]
Risk factorsFamily history, pulmonary embolism, HIV/AIDS, sickle cell disease, cocaine use, COPD, sleep apnea, living at high altitudes[5][4]
Diagnostic methodFollowing ruling out other potential causes[1]
TreatmentSupportive care, various medications, lung transplantation[1][6]
MedicationEpoprostenol, treprostinil, iloprost, bosentan, ambrisentan, macitentan, sildenafil[1]
Frequency1,000 new cases a year (US)[2]

Pulmonary hypertension (PH or PHTN) is a condition of increased blood pressure in the arteries of the lungs.[7] Symptoms include shortness of breath, fainting, tiredness, chest pain, swelling of the legs, and a fast heartbeat.[7][2] The condition may make it difficult to exercise.[7] Onset is typically gradual.[8] According to the definition at the 6th World Symposium of Pulmonary Hypertension in 2018, a patient is deemed to have pulmonary hypertension if the pulmonary mean arterial pressure is greater than 20mmHg at rest, revised down from a purely arbitrary 25mmHg, and pulmonary vascular resistance (PVR) greater than 3 Wood units.

The cause is often unknown.[1] Risk factors include a family history, prior pulmonary embolism (blood clots in the lungs), HIV/AIDS, sickle cell disease, cocaine use, chronic obstructive pulmonary disease, sleep apnea, living at high altitudes, and problems with the mitral valve.[5][4] The underlying mechanism typically involves inflammation and subsequent remodeling of the arteries in the lungs.[5] Diagnosis involves first ruling out other potential causes.[1]

As of 2022 there was no cure for pulmonary hypertension,[6] although research to find a cure is ongoing. Treatment depends on the type of disease.[6] A number of supportive measures such as oxygen therapy, diuretics, and medications to inhibit blood clotting may be used.[1] Medications specifically used to treat pulmonary hypertension include epoprostenol, treprostinil, iloprost, bosentan, ambrisentan, macitentan, and sildenafil, tadalafil, selexipag, riociguat.[1] Lung transplantation may be an option in severe cases.[6]

The frequency of occurrence is estimated at 1,000 new cases per year in the United States.[4][2] Females are more often affected than males.[2] Onset is typically between 20 and 60 years of age.[4] Pulmonary hypertension was identified by Ernst von Romberg in 1891.[9][1]

  1. ^ a b c d e f g h i j k Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RM, Brida M, et al. (October 2022). "2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension". European Heart Journal. 43 (38): 3618–3731. doi:10.1093/eurheartj/ehac237. PMID 36017548.
  2. ^ a b c d e "Pulmonary arterial hypertension". Genetics Home Reference. January 2016. Archived from the original on 28 July 2017. Retrieved 30 July 2017.
  3. ^ Cite error: The named reference web was invoked but never defined (see the help page).
  4. ^ a b c d e "Who Is at Risk for Pulmonary Hypertension?". NHLBI – NIH. 2 August 2011. Archived from the original on 31 July 2017. Retrieved 30 July 2017.
  5. ^ a b c "Causes and Risk Factors". NHLBI, NIH. 24 March 2022.
  6. ^ a b c d "Treatment". NHLBI, NIH. 24 March 2022. Retrieved 22 August 2023.
  7. ^ a b c "What Is Pulmonary Hypertension?". NHLBI, NIH. 1 May 2023.
  8. ^ "How Is Pulmonary Hypertension Diagnosed?". NHLBI – NIH. 2 August 2011. Archived from the original on 28 July 2017. Retrieved 30 July 2017.
  9. ^ von Romberg E (1891–1892). "Über Sklerose der Lungenarterie". Dtsch Arch Klin Med (in German). 48: 197–206.

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