Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Asthma and COPD
- Part II Diffuse parenchymal lung disease
- Part III Infection
- Part IV Pulmonary vascular diseases
- 17 Pathophysiology of pulmonary vascular disease
- 18 Current treatment of pulmonary vascular diseases
- 19 Future treatment of pulmonary vascular diseases
- Part V Lung cancer
- Part VI Cough
- Index
18 - Current treatment of pulmonary vascular diseases
from Part IV - Pulmonary vascular diseases
Published online by Cambridge University Press: 15 August 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Asthma and COPD
- Part II Diffuse parenchymal lung disease
- Part III Infection
- Part IV Pulmonary vascular diseases
- 17 Pathophysiology of pulmonary vascular disease
- 18 Current treatment of pulmonary vascular diseases
- 19 Future treatment of pulmonary vascular diseases
- Part V Lung cancer
- Part VI Cough
- Index
Summary
Introduction
The normal pulmonary circulation is an adaptable compliant system, allowing for large variations in blood flow with relatively small changes in resistance and pulmonary artery pressure. This flexibility is gradually lost in the face of progressive vascular damage due to an intrinsic disease process or a recurrent acute insult, and results in pulmonary hypertension.
The pathological changes were first described by Romberg in 1891 in a patient with unexplained pulmonary arteriosclerosis. In 1951, Dresdale et al. coined the term primary pulmonary hypertension and widespread awareness of the disease came with the epidemic of pulmonary hypertension, blamed on the use of the appetite suppressant aminorex fumarate, that swept Europe in 1967. It took almost 90 years for the first effective medical and surgical treatment to become available, but in the past 10 years there have been dramatic improvements in both quality of life and survival with the use of calcium channel blockers and prostacyclin. This has led to increasing recognition of the important role that pulmonary vascular disease plays in many disease processes, and renewed interest in early diagnosis and intervention.
Definition and classification
Pulmonary hypertension is defined as a mean pulmonary artery pressure of over 25 mmHg at rest or 30 mmHg during exercise.
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- Drugs for the Treatment of Respiratory Diseases , pp. 475 - 503Publisher: Cambridge University PressPrint publication year: 2003