pulmonary disorders
Pulmonary Hypertension
Key Points
Pulmonary hypertension is classified into 5 groups. Suspect pulmonary hypertension if patients have dyspnea unexplained by another clinically evident cardiac or pulmonary disorder. Begin diagnostic testing with chest x-ray, spirometry, ECG, and transthoracic Doppler echocardiography. Confirm the diagnosis by right heart catheterization. Treat group 1 by giving combination therapy with vasodilators and, if these are ineffective, consider lung transplantation. Consider treating group 3 with inhaledtreprostinil. Treat group 4 with pulmonary thromboendarterectomy unless the patient is not a candidate for surgery. Treat groups 2, 3, and 5 by managing the underlying disorder, treating symptoms, and sometimes using other measures. 