title: Pulmonary arterial hypertension: an update on diagnosis and treatment.
abstract: Pulmonary arterial hypertension is defined as a mean pulmonary arterial pressure greater than 25 mm Hg at rest or 30 mm Hg during physical activity. Pulmonary arterial hypertension is classified into subgroups, including idiopathic, heritable, and pulmonary arterial hypertension associated with other conditions. A detailed history, thorough physical examination, and most importantly, a high index of suspicion are essential to diagnosis. Evaluation includes echocardiography and exclusion of other causes of symptoms. Targeted laboratory testing can help identify the subgroup of pulmonary arterial hypertension. Right heart catheterization is required to confirm the diagnosis. Standard treatment options include oral anticoagulation, diuretics, oxygen supplementation, and for a small percentage of patients, calcium channel blockers. Newer treatments include prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase type 5 inhibitors. Combination therapy has been shown to improve pulmonary arterial pressure, but more research is needed. Interventional procedures for patients with pulmonary arterial hypertension include balloon atrial septostomy and lung transplantation.
authors: University of Illinois at Chicago College of Medicine, 60612, USA. rstring@uic.edu
authors: Richard
authors: R
authors: Stringham
authors: Nipa R
authors: NR
authors: Shah
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D006328:Cardiac Catheterization; D004452:Echocardiography; D065128:Endothelin Receptor Antagonists; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D058986:Phosphodiesterase 5 Inhibitors; D011379:Prognosis; D044062:Prostaglandins I / Q000627:therapeutic use; D011651:Pulmonary Artery / Q000503:physiopathology; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D065128:Endothelin Receptor Antagonists; D058986:Phosphodiesterase 5 Inhibitors; D044062:Prostaglandins I; D014665:Vasodilator Agents