Document Detail


Pulmonary hypertension: diagnosis and management.
MedLine Citation:
PMID:  19181654     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Michael D McGoon; Garvan C Kane
Related Documents :
9236374 - Pulmonary hypertension caused by medial hypertrophy associated with aortic stenosis and...
9481764 - Impaired left ventricular myocardial metabolism in patients with pulmonary hypertension...
16319344 - Autoimmunity and pulmonary hypertension: a perspective.
20814784 - Age-related clinical characteristics of isolated congenital unilateral absence of a pul...
9356074 - Profound hypotension in blunt trauma associated with superior gluteal artery rupture wi...
8412094 - Stress distributions in vascular aneurysms: factors affecting risk of aneurysm rupture.
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    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Activin Receptors, Type II / genetics
Algorithms
Angina, Unstable / etiology
Antihypertensive Agents / therapeutic use
Bone Morphogenetic Protein Receptors, Type II / genetics
Calcium Channel Blockers / therapeutic use
Drug Therapy, Combination
Exercise
Female
Humans
Hypertension, Pulmonary / diagnosis*,  genetics,  physiopathology,  therapy*
Insurance Coverage
Insurance, Health
Phosphodiesterase Inhibitors / therapeutic use
Pregnancy
Receptors, Endothelin / antagonists & inhibitors
Severity of Illness Index
Syncope / etiology
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Phosphodiesterase Inhibitors; 0/Receptors, Endothelin; EC 2.7.11.30/ACVRL1 protein, human; EC 2.7.11.30/Activin Receptors, Type II; EC 2.7.11.30/BMPR2 protein, human; EC 2.7.11.30/Bone Morphogenetic Protein Receptors, Type II
Comments/Corrections
Erratum In:
Mayo Clin Proc. 2009 Apr;84(4):386

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


Previous Document:  The top 10 things nephrologists wish every primary care physician knew.
Next Document:  Circulating neutrophil gelatinase-associated lipocalin: a useful biomarker for assessing disease act...