Pulmonary Hypertension - ECAB

Pulmonary Hypertension (PH) is a complex, multifactorial condition defined by a mean pulmonary artery pressure (mPAP) ≥25 mmHg and a pulmonary capillary wedge pressure ≤15 mmHg, confirmed via cardiac catheterization. This condition spans a wide spectrum of etiologies—from drug and toxin exposure, portal hypertension, HIV, and collagen vascular diseases, to persistent pulmonary hypertension of the newborn (PPHN). PH frequently coexists with various forms of cardiac and pulmonary diseases, presenting with nonspecific symptoms like breathlessness, fatigue, chest pain, and syncope, often delaying diagnosis.

In developing countries, the challenge of managing PH is compounded by healthcare disparities, limited access to diagnostic resources, and the prohibitive cost of newer therapies. Additionally, advanced pulmonary vascular disease due to uncorrected congenital heart disease (CHD) remains a major health burden. This underscores the urgent need for region-specific guidelines, increased physician awareness, and policy interventions to improve drug accessibility and affordability.

This resource offers a comprehensive overview of the clinical features, diagnostic strategies, and management challenges of PH, particularly in resource-limited settings, emphasizing the importance of tailored approaches to diagnosis and care.

Key Features:

•  Comprehensive Etiologic Overview: Covers a wide range of PH causes including congenital, infectious, autoimmune, and drug-related etiologies.
•  Focus on Global and Regional Challenges: Highlights the diagnostic and therapeutic limitations in low- and middle-income countries, especially regarding drug accessibility and healthcare infrastructure.
•  Real-World Prevalence Insights: Discusses challenges in estimating true PH prevalence due to underdiagnosis and limited healthcare access in developing nations.
•  Clinical Presentation Detailed: Describes hallmark symptoms and physical findings, including right ventricular lift, loud P2, and murmurs of tricuspid and pulmonary regurgitation.
•  Diagnostic Workup Outlined: Reviews both standard and advanced diagnostic tools such as cardiac catheterization, HRCT, CMR, ABGs, and nocturnal oxygen saturation monitoring.
•  Therapeutic Limitations & Needs: Addresses the gap between available treatments and affordability, and the pressing need for policy-driven solutions in countries like India.
•  Advocacy and Recommendations: Stresses the importance of clinical education, guideline development, and cost-effective treatment strategies for effective PH management.