Med. praxi. 2016;13(5):238-241 | DOI: 10.36290/med.2016.051

Who would think of pulmonary hypertension in the general practitioner's surgery?

doc. MUDr. Pavel Jansa, Ph.D.

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

Všeobecná fakultní nemocnice a 1. lékařská fakulta UK, Praha, ČR

Pulmonary hypertension includes conditions characterized by a mean pulmonary artery pressure which 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: December 1, 2016  Show citation