Description
Pulmonary hypertension is defined as a mean pulmonary artery pressure (mPAP) =25 mmHg, with Pulmonary Capillary Wedge Pressure = 15 mmHg, measured by cardiac catheterization. The etiology of PH has a varied spectrum extending right from Drugs, toxins and portal hypertension to HIV, Collagen Vascular Diseases and Persistent Pulmonary Hypertension of Newborn, etc. The estimation of disease prevalence has been nearly impossible owing to the geographic distribution and economic diversity, along with significant regional variations in human development and healthcare infrastructure. A large number of patients with PH never reach the health centers capable of diagnosing the disease condition correctly. Advance pulmonary vascular disease as a result of uncorrected CHD is a major health challenge in the developing world. PH exists as a major component of many forms of cardiac and pulmonary disease. While breathlessness is the most common feature of PH, patients often also present with chest pain, syncope, fatigue, weakness and abdominal distension. The precordial signs include a right ventricular lift, accentuated pulmonary component of S2, a pansystolic murmur of Tricuspid regurgitation, a diastolic murmur of pulmonary regurgitation and a right ventricular S3. The standard diagnostic workup in developed countries includes a series of investigations to rule out the secondary causes. Additional tests are required to estimate the disease severity and plan the appropriate treatment. Th
Chapter
Pulmonary Hypertension in India and the Developing World
Epidemiology of Pulmonary Hypertension in the Developing World
The Challenge of Managing Pulmonary Hypertension with Limited Resources
The Challenge of Early Diagnosis and Referral
Specialized Clinics and Service
Management of Pulmonary Hypertension
The Impact of Newly Introduced Drugs for Pulmonary Hypertension
Addressing the Problem of Pulmonary Hypertension in the Developing World
Specialized Clinics and Service
Management of Pulmonary Hypertension
The Impact of Newly Introduced Drugs for Pulmonary Hypertension
Addressing the Problem of Pulmonary Hypertensionin the Developing World
Clinical and Genetic Aspects of Pulmonary Hypertension: An Overview
Physiological and Genetic Aspects
Bone Morphogenetic Protein Receptor Type 2
Activin Receptor-Like Kinase
Expression Profiling in Human Primary Pulmonary Hypertension
Evaluation of a Patient with Pulmonary Hypertension: What is Necessary for Diagnosis, Classification and Prognostication
Two-Dimensional Echocardiography
Doppler Evaluation to Assess Hemodynamics
Blood Tests and Biomarkers
Confirming The Diagnosis and Establishing Causality
CT Scan and CT Angiography of Pulmonary Vessels
Magnetic Resonance Imaging of Heart and Pulmonary Vasculature
Right Heart Catheterization
Six-minute Walk Test and Cardiopulmonary Exercise Testing
Evidence-based Management of Pulmonary Arterial Hypertension
Prostacyclin Analogs or Prostanoids
Endothelin Receptor Antagonists
Phosphodiesterase-5 (PDE-5) Inhibitors
Rationale for Combination Therapy35
Strategies for Combination Therapy
Other Conventional and Supportive Therapies
Novel Treatments for the Future
Vasoactive Intestinal Polypeptide
Inhibition of Angiogenesis
Disease-Targeted Therapy of Pulmonary Arterial Hypertension Based On 2007 Accp Recommendations2
Add-on or Combination Therapy
Assessment of Operability in Left to Right Shunts: Guidelines for the Practising Cardiologists
Clinical Assessment of Operability
Other Factors Influencing Pulmonary Vasculature
Pulmonary Hypertension Early After Congenital Heart Surgery: Prevention and Treatment
Right Ventricular Dysfunction, Ventricular Interdependence and Pulmonary Hypertensive Crisis
Right Ventricular (RV) Failure Management
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