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2017 ; 114
(5
): 73-84
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Pulmonary Hypertension
#MMPMID28241922
Hoeper MM
; Ghofrani HA
; Grünig E
; Klose H
; Olschewski H
; Rosenkranz S
Dtsch Arztebl Int
2017[Feb]; 114
(5
): 73-84
PMID28241922
show ga
BACKGROUND: About 1% of adults suffer from pulmonary hypertension (PH). The
various types of PH differ widely with respect to their incidence, clinical
significance, and treatment. METHODS: Selective review of the literature in
association with a consensus conference. RESULTS: Pulmonary hypertension is
divided into five major categories. Those that are of particular clinical
relevance are pulmonary arterial hypertension, chronic thromboembolic pulmonary
hypertension, and pulmonary hypertension due to left heart and lung diseases. Ten
drugs from five different substance classes are now available for the treatment
of PH and are often given in combination. The treatment strategy is determined by
risk stratification based on the severity of disease, along with the clinical
phenotype and possible accompanying illnesses. The preferred treatment for
chronic thromboembolic pulmonary hypertension is surgical pulmonary
endarterectomy; inoperable patients are treated with drugs and endovascular
interventions. PH due to left heart and lung diseases generally calls for
specific treatment of pulmonary hypertension only if there is severe right-heart
strain. CONCLUSION: The diagnosis and treatment of severe forms of PH, in
particular, pulmonary arterial hypertension and chronic thromboembolic pulmonary
hypertension, are complex and are best carried out in close cooperation between
the local physician and specialized centers.