title: Special Situations in Pulmonary Hypertension: Pregnancy and Right Ventricular Failure.
abstract: Despite rapid advances in medical therapy, pregnancy and right ventricular (RV) failure predicts a poor prognosis in patients with pulmonary arterial hypertension. Evidence-based therapy for pulmonary arterial hypertension should be initiated early in the disease course to decrease RV wall stress and prevent RV remodeling and fibrosis. In patients with acutely decompensated RV failure, an aggressive and multifaceted approach must be used; a thorough search for triggering factors for the decompensation is a key part of the successful management strategy. Patients with refractory RV failure who are not candidates for surgical intervention should be referred to palliative care to maximize quality of life and symptom relief.
authors.affiliation: Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA. Electronic address: Jana.Svetlichnaya@ucsf.edu.
authors.forename: Jana
authors.initials: J
authors.lastname: Svetlichnaya
authors.affiliation: Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Munir
authors.initials: M
authors.lastname: Janmohammed
authors.affiliation: Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: De Marco
mesh_terms: D005260:Female; D014943:Global Health; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D011669:Pulmonary Wedge Pressure; D018497:Ventricular Dysfunction, Right / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D020257:Ventricular Remodeling
keywords: Pregnancy; Pulmonary arterial hypertension; Pulmonary vascular disease; Right ventricular failure