Diagnosing and treating primary pulmonary hypertension.
Primary pulmonary hypertension (PPH) is a pulmonary vascular disease characterized by an elevation in mean pulmonary artery pressure and pulmonary vascular resistance. Recently, PPH gained national attention because of its association with appetite suppressants. PPH may also be associated with pregnancy, hypothyroidism, autoimmune disorders, human immunodeficiency virus infection, and the use of drugs such as oral contraceptives and cocaine. Patients with PPH may report dyspnea on exertion and fatigue. Early diagnosis is crucial. New therapeutic regimens have dramatically reduced mortality rates and improved quality of life by halting the progression of pulmonary vascular remodeling and averting right-sided heart failure. These therapies include high-dose calcium channel antagonists, anticoagulants, and continuous intravenous prostacyclin. Lung or heart-lung transplantation remains a viable therapeutic option for patients who are treated late in the disease process, who are not responsive to medical management, or who remain symptomatic and continue to deteriorate.
Frazier
S K
SK
Department of Adult Health and Illness, College of Nursing, Ohio State University, Columbus, USA.
D000328:Adult; D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003663:Decision Trees; D003937:Diagnosis, Differential; D018450:Disease Progression; D011464:Epoprostenol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016040:Lung Transplantation; D009722:Nurse Practitioners; D011247:Pregnancy; D011320:Primary Health Care
D000925:Anticoagulants; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D011464:Epoprostenol