Document Detail

Pulmonary hypertension: diagnosis and management.
MedLine Citation:
PMID:  19181654     Owner:  NLM     Status:  MEDLINE    
Pulmonary arterial hypertension is a progressive, symptomatic, and ultimately fatal disorder for which substantial advances in treatment have been made during the past decade. Effective management requires timely recognition and accurate diagnosis of the disorder and appropriate selection among therapeutic alternatives. Despite progress in treatment, obstacles remain that impede the achievement of optimal outcomes. The current article provides an overview of the pathobiologic mechanisms of pulmonary arterial hypertension, including genetic substrates and molecular and cellular mechanisms, and describes the clinical manifestations and classification of pulmonary arterial hypertension. The article also reviews established approaches to evaluation and treatment, with emphasis on the appropriate application of calcium channel blockers, prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase 5 inhibitors. In addition, the authors discuss unresolved issues that may complicate patient management, such as the clinical importance of mild or exercise-related pulmonary arterial hypertension, and they identify avenues by which treatment may advance in the future through the use of combination treatment, outcomes assessment, and exploration of alternative pharmacologic strategies.
Michael D McGoon; Garvan C Kane
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  84     ISSN:  1942-5546     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-03-03     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  191-207     Citation Subset:  AIM; IM    
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MeSH Terms
Activin Receptors, Type II / genetics
Angina, Unstable / etiology
Antihypertensive Agents / therapeutic use
Bone Morphogenetic Protein Receptors, Type II / genetics
Calcium Channel Blockers / therapeutic use
Drug Therapy, Combination
Hypertension, Pulmonary / diagnosis*,  genetics,  physiopathology,  therapy*
Insurance Coverage
Insurance, Health
Phosphodiesterase Inhibitors / therapeutic use
Receptors, Endothelin / antagonists & inhibitors
Severity of Illness Index
Syncope / etiology
Reg. No./Substance:
0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Phosphodiesterase Inhibitors; 0/Receptors, Endothelin; EC protein, human; EC Receptors, Type II; EC protein, human; EC Morphogenetic Protein Receptors, Type II
Erratum In:
Mayo Clin Proc. 2009 Apr;84(4):386

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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