Actualización en el diagnóstico y terapéutica en hipertensión pulmonar arterial
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Fecha
2006
Profesor/a Guía
Facultad/escuela
Idioma
Título de la revista
ISSN de la revista
Título del volumen
Editor
Sociedad Médica de Santiago
Nombre de Curso
Licencia CC
Licencia CC
Resumen
Resumen: Pulmonary Arterial Hypertension includes a heterogeneous group of disorders with a common genetic, pathological and hemodinamyc origin. It is characterized by a high pulmonary artery pressure due to a primary vascular disease, as a consequence of genetic and environmental factors. The common pathway is a vascular imbalance towards vasoconstriction and proliferation inside the small vessels. According to the World Health Organization, 2003, Pulmonary
Arterial Hypertension is classified as idiopathic, familiar or associated to connective tissue diseases, HIV, drugs, porto-pulmonary hypertension, congenital intracardiac shunts and others. The
diagnosis is based in hemodynamics. Echocardiogram is a non invasive and right ventricular catheterization is an invasive diagnostic tool. Follow up is based on a clinical and functional assessment through functional class classification, dyspnea scores and 6-minute walking test. The prognosis is historically devastating but new therapies are changing the natural history of the disease. New treatments have demonstrated improvement in symptoms, hemodynamic profiles and survival. Intravenous, subcutaneous or inhaled prostanoids such as Epoprostenol, Treprostinil or Iloprost respectively have been approved for Pulmonary Arterial Hypertension treatment as well as oral endothelial receptor blockers. They are all considered first line treatments for arterial pulmonary hypertensive patients with even better benefits than lung transplantation. Phosphodiesterase inhibitors (Sildenafil), have been recently approved for the treatment of pulmonary arterial hypertension.
Notas
Indexación: Scielo
Palabras clave
Hypertension, Pulmonary, Prostaglandins, Receptors, Vascular endothelial growth factor, Sildenafil, Hipertension pulmonar
Citación
Revista Médica de Chile, Vol. 134, N° 7, pp. 902-909, 2006.