[Vaskuläre Dyspnoe: Pulmonale Hypertonie]

Area of Science:

• Cardiology and Pulmonology
• Hemodynamics
• Diagnostic Imaging

Context:

• Pulmonary hypertension (PH) is defined as mean pulmonary artery pressure > 20 mmHg.
• Echocardiography screens for PH, but right heart catheterization confirms diagnosis and measures key hemodynamic parameters.
• PH classification includes precapillary, postcapillary, and combined forms based on PAWP and PVR.
• Supportive therapies like diuretics and oxygen are common, while specific treatments target pulmonary arterial hypertension and CTEPH.

Purpose:

• To outline the diagnostic criteria and therapeutic approaches for pulmonary hypertension (PH).
• To differentiate between various PH classifications based on hemodynamic measurements.
• To highlight the complexity of PH management, emphasizing the need for specialized centers.

Summary:

• Right heart catheterization is essential for diagnosing PH by measuring pulmonary arterial pressures, PAWP, CO, and PVR.
• PH is categorized into precapillary, postcapillary, and combined types based on PAWP and PVR thresholds.
• Treatment strategies are tailored to PH type, including supportive care and specific interventions for pulmonary arterial hypertension and CTEPH.

Impact:

• Accurate PH diagnosis and classification are crucial for effective treatment selection.
• Understanding hemodynamic parameters guides therapeutic decisions in complex PH cases.
• Management of PH, particularly pulmonary vascular diseases, necessitates expertise found in specialized centers.