[Secondary pulmonary hypertension in the elderly: pathophysiological and clinical aspects from an observed case]

The authors report the case of a 76-year-old woman with severe pulmonary hypertension (80 mmHg). She had been suffering for years from chronic bronchitis and presented tricuspid insufficiency. The case report refers to the association between valvular insufficiency and/or chronic bronchitis and pulmonary hypertension. This condition--if severe--results in progressive disability and death. The treatment of severe pulmonary hypertension has not been taken into account, since it has proven to be ineffective and has side effects. The early detection and the prevention of the underlying causes represent the only available therapy. Sclerotic valvulopathy occurs more frequently in the elderly; it represents the major cause of valvular insufficiency/stenosis, especially if compared to the significant decrease in rheumatic disease in Western countries. Chronic bronchitis is characterized by a slow progression, in patients younger than fifty, by a decay worsened by aging. These data show that symptomatic pulmonary hypertension may often occur in the elderly (age > or =65 years). This paper results from our clinical experience on preventive measures in elderly patients with symptomatic pulmonary hypertension. If the material presented in this work succeeds in promoting new research or possible preventive measures to arrest or to slow down the course of this condition in the elderly, it will hit its target.