A Practical Guide to Portal Hypertension: The Basics of Diagnostics and Medical Management

Portal hypertension is a hemodynamic consequence of altered mesenteric circulation. The chief drivers of portal hypertension are rising hepatic resistance and venous remodeling. A major challenge in treating patients with portal hypertension is early diagnosis because most patients progress through disease asymptomatically. Noninvasive tests such as serologic markers and elastography are the basis of determining if patients have clinically significant portal hypertension. If identified early, patients placed on carvedilol and who undergo etiologic cure may be able to delay or avert decompensation altogether. This paper reviews the pathophysiology, diagnosis, and medical management of portal hypertension.