RESUMO
La hipertensión pulmonar (HP) es un trastorno hemodinámico que se puede observar en el contexto de una serie de patologías de diferente índole. Se define por la presencia de un valor medio de presión en arteria pulmonar (PAPm) ≥ 25 mmHg. Desde un punto de vista clínico, se clasifica en 5 grupos; de ellos el grupo I o hipertensión arterial pulmonar, aunque infrecuente, merece especial consideración por las implicaciones terapéuticas específicas que conlleva. Sobre la base de una sospecha clínica y/o resultado de un ecocardiograma, el diagnóstico de esta entidad se basa en el seguimiento de un estricto protocolo que debe incluir la realización de un cateterismo cardiaco derecho. La HP es una enfermedad progresiva y grave cuyo pronóstico va a depender fundamentalmente del grado de afectación del ventrículo derecho. Una vez confirmado el diagnóstico, resulta indispensable evaluar la gravedad del cuadro para instaurar el tratamiento más acorde a la situación clínica del paciente. Para ello, utilizaremos diversos parámetros clínicos, biológicos, ecocardiográficos-hemodinámicos y relacionados con la capacidad de esfuerzo (AU)
Pulmonary hypertension (PH) is a hemodynamic disorder that occurs in a series of distinct diseases and is defined by the presence of a mean pulmonary artery pressure of ≥ 25 mm Hg. Clinically, this disorder is classified in five groups. Of these, group I, or pulmonary arterial hypertension (PAH), although infrequent, deserves special attention due to the specific therapeutic implications involved. Based on clinical suspicion and/or the results of echocardiogram, the diagnosis of this entity is established by following a strict protocol that should include right-sided cardiac catheterization. PH is a severe, progressive disease whose prognosis mainly depends on the degree of right ventricular involvement. Once the diagnosis has been confirmed, severity must be evaluated to initiate the most appropriate treatment for the patients status. To do this, several clinical, biological, and echocardiographic-hemodynamic parameters and indicators of exercise capacity can be used (AU)
Assuntos
Humanos , Hipertensão Pulmonar/classificação , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/fisiopatologia , Disfunção Ventricular Direita/complicações , Disfunção Ventricular Direita/diagnóstico , Disfunção Ventricular Direita/fisiopatologia , Algoritmos , Técnicas de Diagnóstico Cardiovascular , Técnicas de Diagnóstico do Sistema Respiratório , Progressão da Doença , Tolerância ao Exercício , Hemodinâmica , Pneumopatias/complicações , Pneumopatias/diagnóstico , Pneumopatias/fisiopatologia , PrognósticoRESUMO
Pulmonary hypertension (PH) is a hemodynamic disorder that occurs in a series of distinct diseases and is defined by the presence of a mean pulmonary artery pressure of ≥ 25 mm Hg. Clinically, this disorder is classified in five groups. Of these, group I, or pulmonary arterial hypertension (PAH), although infrequent, deserves special attention due to the specific therapeutic implications involved. Based on clinical suspicion and/or the results of echocardiogram, the diagnosis of this entity is established by following a strict protocol that should include right-sided cardiac catheterization. PH is a severe, progressive disease whose prognosis mainly depends on the degree of right ventricular involvement. Once the diagnosis has been confirmed, severity must be evaluated to initiate the most appropriate treatment for the patient's status. To do this, several clinical, biological, and echocardiographic-hemodynamic parameters and indicators of exercise capacity can be used.
