WHAT IS PH? : MANAGEMENT

DEFINITION AND CLASSIFICATION / PATHOPHYSIOLOGY / EPIDEMIOLOGY / CLINICAL PRESENTATION / MANAGEMENT / NATURAL HISTORY

The management of a patient with pulmonary hypertension depends upon the aetiology and the broad principles of management are shown in the table below. Patients who could possibly be in classes I, IV and V should be referred to the Scottish Pulmonary Vascular Unit for further investigation.

Class	Treatment
I. Pulmonary arterial hypertension	Refer to SPVU Prostanoids, endothelin receptor antagonists, phosphodiesterase inhibitors
II. PH with left heart disease	ACEI, ?-blockers, diuretics
III. PH with lung diseases/ hypoxaemia	LTOT
IV. PH due to chronic thrombotic and/or embolic disease Proximal Distal	Refer to SPVU Thromboendarterectomy As PAH
V. Miscellaneous	Refer to SPVU