Pulmonary arterial hypertension
Pulmonary arterial hypertension is a subgroup of a specific subgroup of
pulmonary hypertension (PH) defined as a condition of slowly progressive
disorder as a result of abnormally high blood pressure in the blood
vessel, including pulmonary artery, pulmonary vein, or pulmonary
capillaries, that carries blood from the heart to the lungs due to
narrowing in diameter of most of the very small arteries throughout the
lungs of that increased resistance to blood flow, leading to right
heart failure and death. Because the phrase pulmonary arterial
hypertension is long and pulmonary hypertension is a bit shorter the
phrase. Pulmonary hypertension is often used in place of pulmonary
arterial hypertension(a). According to statistic, approximately over
1,000 new cases of pulmonary arterial hypertension are diagnosed each
year, in the United States alone.
A. Complications
1. Right-sided heart failure
Pulmonary arterial hypertension (PAH) is a progressive disease in which
increased pulmonary arterial pressure and remodelling eventually lead to
right heart failure and death. Idiopathic and familial PAH occur far
more frequently in women than in men(12).
2. Sudden Cardiac Death
According to the study by the Onassis Cardiac Surgery Center, Pulmonary
Arterial Hypertension (PAH) is a disease of small pulmonary arteries,
characterized by vascular proliferation and remodeling. Progressive
increase in pulmonary vascular resistance ultimately leads to right
ventricular heart failure and death(13).
3. Arrhythmia
Cardiac arrhythmias are important contributors to morbidity and
mortality in patients with pulmonary arterial hypertension (PAH). Such
patients manifest a substrate resulting from altered autonomics,
repolarization abnormalities, and ischemia. Supraventricular arrhythmias
such as atrial fibrillation and flutter are associated with worsened
outcomes, and maintenance of sinus rhythm is a goal(14).
4. Bleeding and thrombosis
According to the study by DRK Kliniken Berlin Köpenick, On one hand,
thrombosis is one of the key pathophysiologic features of PAH (besides
vasoconstriction, proliferation and inflammation). On the other hand,
the incidence of bleeding events is increased in PAH patients(15).
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Sources
(a) http://pulmonaryhypertensionrn.com/ph-vs-pah/
(8a) http://www.ncbi.nlm.nih.gov/pubmed/23625955
(12)
http://www.ncbi.nlm.nih.gov/pubmed/23625955
(13) http://www.ncbi.nlm.nih.gov/pubmed/23271814
(14) http://www.ncbi.nlm.nih.gov/pubmed/23009914
(15) http://www.ncbi.nlm.nih.gov/pubmed/19335748
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