Pulmonary hypertension

Therapy is determined by the underlying cause. When the condition is secondary to hypoxia accompanying chronic obstructive pulmonary disease, long-term oxygen therapy improves symptoms and prognosis; anticoagulation is essential when the cause is multiple pulmonary emboli.

Primary pulmonary hypertension: verapamil may give symptomatic benefit, also continuous intravenous infusion of prostaglandin. Evidence suggests that endothelin, a powerful endogenous vasoconstrictor, may play a pathogenic role, and bosentan, an endothelin-receptor antagonist may improve exercise tolerance. Heart and lung transplantation is recommended for younger patients.

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