pulmonary disorders
Pulmonary Hypertension
Introduction
Pulmonary hypertension is increased pressure in the pulmonary circulation. It has many secondary causes; some cases are idiopathic. In pulmonary hypertension, pulmonary vessels may become constricted, pruned, lost, and/or obstructed. Severe pulmonary hypertension leads to right ventricular overload and failure. Symptoms are fatigue, exertional dyspnea, and, occasionally, chest discomfort and syncope. Diagnosis is made by finding elevated pulmonary artery pressure (estimated by echocardiography and confirmed by right heart catheterization). Treatment is with pulmonary vasodilators and diuretics. In some advanced cases, lung transplantation is an option. Prognosis is poor overall if a treatable secondary cause is not found. There are three distinct hemodynamic profiles of pulmonary hypertension (see also table Hemodynamic Profiles of Pulmonary Hypertension ): Pre-capillary pulmonary hypertension Post-capillary pulmonary hypertension Combined pre- and post-capillary pulmonary hypertension 