Pulmonary hypertension

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]

Quick facts: Pulmonary hypertension, Other names, Specialt... ▼

Pulmonary hypertension
Other names	Pulmonary arterial hypertension,[1] Ayerza syndrome[2]
Pulmonary hypertension
Specialty	Pulmonology, cardiology
Symptoms	Chest pain, fatigue[3]
Usual onset	20 to 60 years old[4]
Duration	Long term[1]
Causes	Unknown[1]
Risk factors	Family history, pulmonary embolism, HIV/AIDS, sickle cell disease, cocaine use, COPD, sleep apnea, living at high altitudes[5][4]
Diagnostic method	Following ruling out other potential causes[1]
Treatment	Supportive care, various medications, lung transplantation[1][6]
Medication	Epoprostenol, treprostinil, iloprost, bosentan, ambrisentan, macitentan, sildenafil[1]
Frequency	1,000 new cases a year (US)[2]

According to the latest definition at the 6th World Symposium of Pulmonary Hypertension, a patient is deemed to have pulmonary hypertension if the pulmonary mean arterial pressure is greater than 20mmHg at rest, and Pulmonary Vascular Resistance PVR >3 Wood units. This was revised down from 25mmHg to improve sensitivity. Furthermore, the initial cutoff of 25mmHg was purely arbitrary.

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]

There is currently no cure for pulmonary hypertension, although research on a cure is ongoing.[7] 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.[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]