Pulmonary hypertension medical therapy: Difference between revisions
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*Decrease the hospitilization rate. | *Decrease the hospitilization rate. | ||
*Improve Survival. | *Improve Survival. | ||
==ESC/ERS Recommendations for General measures== | |||
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===[[ESC/ERS guidelines classification scheme#Classification of Recommendations|Class I]]=== | |||
'''1.''' It is recommended to avoid pregnancy in patients with PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' | |||
'''2.''' Immunization of PAH patients against influenza and pneumococcal infections is recommended ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' | |||
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]=== | |||
'''1.''' Physically deconditioned PAH patients should be considered for supervised exercise rehabilitation ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
'''2.''' Psychosocial support should be considered in patients with PAH ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
'''3.''' In-flight oxygen administration should be considered for patients in WHO-FC III and IV and those with arterial oxygen pressure consistently less than 60mmHg ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
'''4.''' Epidural anesthesia instead of general anesthesia should be utilised if possible for elective surgery ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]=== | |||
'''1.''' Excessive physical activity that leads to distressing symptoms is not recommended in patients with PAH''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'}} | |||
Revision as of 18:40, 8 September 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Assistant Editor(s)-in-Chief: Ralph Matar,
Medical Therapy of Pulmonary Hypertension
Overview
Treatment of pulmonary hypertension has passed through a dramatic evolution in the past few years,in part owing to advances in the understanding of the basic pathophysiological contributors to the disease. However, despite all the modern therapeutic agents, pulmonary hypertension remains a chronic disease with no cure.
Before prescribing any medication, the physician must assess the severity, consider supportive treatment and lifestyle changes, then consider the combination of different drugs and the possibility of further interventions.
Treatment Goals
- Improving the patient's symptoms.
- Enhancing functional capacity.
- Lowering Pulmonary arterial pressure and normalizing cardiac output.
- Prevent or at least slow the progression of the disease.
- Decrease the hospitilization rate.
- Improve Survival.
ESC/ERS Recommendations for General measures
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Class I1. It is recommended to avoid pregnancy in patients with PAH. (Level of Evidence: A) 2. Immunization of PAH patients against influenza and pneumococcal infections is recommended (Level of Evidence: A)
Class IIa1. Physically deconditioned PAH patients should be considered for supervised exercise rehabilitation (Level of Evidence: B) 2. Psychosocial support should be considered in patients with PAH (Level of Evidence: B) 3. In-flight oxygen administration should be considered for patients in WHO-FC III and IV and those with arterial oxygen pressure consistently less than 60mmHg (Level of Evidence: B) 4. Epidural anesthesia instead of general anesthesia should be utilised if possible for elective surgery (Level of Evidence: B)
Class III1. Excessive physical activity that leads to distressing symptoms is not recommended in patients with PAH(Level of Evidence: B)' |
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