Advertisement
Feature Article

Pulmonary hypertension – when to suspect and refer

ALAN M. CAREW, JOHN FEENSTRA

Figures

© image point fr/shutterstock model used for illustrative purposes only
© image point fr/shutterstock model used for illustrative purposes only

Abstract

Pulmonary hypertension is an umbrella term that may describe either a primary, progressive, devastating disorder of the pulmonary vascular system or a complication of an array of medical conditions. Early detection of the former is crucial, as effective treatment is available and can avert an otherwise poor prognosis for these patients.

Key Points

  • The main symptoms of pulmonary hypertension (PH) are progressive dyspnoea, fatigue and exercise intolerance.
  • PH can be associated with various cardiac, respiratory and other systemic disorders and is classified into five groups to help streamline treatment decisions.
  • Diagnosis of the most severe forms of PH is often delayed because of its nonspecific symptoms, leading to detection at a more advanced stage of disease.
  • Expert PH centres specialise in managing patients with Group 1 (pulmonary arterial hypertension) and Group 4 (chronic thromboembolic pulmonary hypertension) disease.
  • Patients with Group 2 or 3 PH (secondary to left heart disease or chronic lung disease) are usually managed primarily by a cardiologist or respiratory physician, respectively, although select patients in these groups may also benefit from review in an expert PH centre.

Figures

© image point fr/shutterstock model used for illustrative purposes only
© image point fr/shutterstock model used for illustrative purposes only