University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Critical Care Medicine


Tom Colletti, DHSc, MPAS, PA-C, DFAAPA


Pulmonary hypertension (PH) is a progressive disease defined by increased mean pressures in the pulmonary arteries. Pulmonary hypertension has many different etiologies and identifying the underlying cause is imperative to the successful management and treatment of the condition to avoid further complications. Pulmonary hypertension etiologies are classified into five groups by the World Health Organization (WHO). These five groups are known as the PH WHO Groups. Group 1 refers to pulmonary arterial hypertension (PAH) deriving from the narrowing, thickening, or stiffness of the pulmonary arteries. Group 2 is pulmonary hypertension caused by left heart disease. Group 3 is PH due to various lung diseases. Group 4 is PH due to chronic blood clots in the lungs. Group 5 is PAH due to unknown or various causes. The World Symposium on Pulmonary Hypertension (WSPH), a group of experts specializing in PAH, met in 2018 for the 6th time to review clinical classification for criteria of diagnosis, evaluation, and management of the disease state. This review serves to provide an overview of the epidemiology, risk factors, pathophysiology, clinical manifestations, diagnosis, and management of these differing etiologies by groups of pulmonary hypertension provided by the WSPH. Despite updated criteria for diagnosis and options for management in pulmonary hypertension, disease complications are common, and prognosis remains poor. Patients who do not respond to medical treatment or therapy require lung transplantation.


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