title: [Diagnosis and treatment of pulmonary hypertension].
abstract: Pulmonary hypertension is defined as a mean pulmonary artery pressure of more than 25 mmHg. There are many possible causes of pulmonary hypertension; pulmonary hypertension has a poor prognosis, irrespective of the underlying cause. The most frequent causes of pulmonary hypertension are left heart failure and lung disease. The diagnostic work up of pulmonary hypertension starts with investigations into left heart failure and lung disease. If these reveal no cause, ventilation perfusion scintigraphy should be carried out so that chronic thrombo-embolic pulmonary hypertension can be demonstrated or excluded. In most cases, chronic thrombo-embolic pulmonary hypertension can be treated curatively by means of pulmonary endarterectomy. If chronic thrombo-embolic pulmonary hypertension is also ruled out, then we speak of pulmonary arterial hypertension. Prostacyclins, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, and soluble guanylyl cyclase stimulators have been shown to be effective in patients with pulmonary arterial hypertension. This condition should be treated at specialist centres.
authors.affiliation: Vrije Universiteit Medisch Centrum, Amsterdam.
authors.forename: Anton
authors.initials: A
authors.lastname: Vonk Noordegraaf
authors.forename: Anco
authors.initials: A
authors.lastname: Boonstra
authors.forename: Thelma C
authors.initials: TC
authors.lastname: Konings
authors.forename: Koen M J
authors.initials: KM
authors.lastname: Marques
authors.forename: Harm Jan
authors.initials: HJ
authors.lastname: Bogaard
mesh_terms: D002908:Chronic Disease; D004691:Endarterectomy; D006162:Guanylate Cyclase / Q000627:therapeutic use; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D018160:Receptors, Cytoplasmic and Nuclear / Q000627:therapeutic use; D012307:Risk Factors; D000071756:Soluble Guanylyl Cyclase; D013923:Thromboembolism / Q000150:complications / Q000175:diagnosis; D016896:Treatment Outcome; D014655:Vascular Resistance / Q000502:physiology
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D018160:Receptors, Cytoplasmic and Nuclear; D006162:Guanylate Cyclase; D000071756:Soluble Guanylyl Cyclase