Pulm HT - Current and Emerging Drugs in Pulmonary Vascular...

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1 Current and Emerging Drugs in Pulmonary Vascular Pharmacology Dr AS Paul DM Seminar 08 September 06 Pulmonary Hypertension ± A mean pressure of greater than 25 mm Hg at rest (normal ~14 mm Hg) or greater than 30 mm Hg during exercise. ± At rest ± sustained vasoconstriction/remodelling ± During exercise ± Reduced distensibility / recruitment of vessels
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2 Diagnostic Classification ± WHO 1998 ± Diagnostic and treatment oriented ± Five descriptive classes ± PPH clubbed with CVD etc ± Heterogeneous group of disorders I Pulmonary Arterial Hypertension ± Primary pulmonary hypertension ± Related to: ± CVD ± Systemic-pulm shunt ± Portal HT ± HIV ± Drugs/toxins ± Persistent pulm HT of newborn ± Others
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3 II Pulm Venous Hypertension ± Lt sided atrial/ventricular heart disease ± Lt sided valvular heart disease ± Ext compression of pul veins ± Fibrosing mediastinitis ± Adenopathy/tumours ± Pulm veno-occlusive disease ± Other III Pulm HT associated with hypoxia ± COPD ± ILD ± Sleep disorders ± Alveolar hypoventilation ± High altitude ± Neonatal lung disease ± Others
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4 IV PHT due to chronic PTE ± Obst of prox pulm arteries ± Obst of distal pulm arteries ± PE (thrombus,tumour,parasites,foreign matter) ± Insitu thrombosis ± Sickle cell disease V PHT : Disorders affecting Pulmonary Vasculature ² Inflammatory ² Schistosomiasis ² Sarcoidosis ² Others ± Pulm capillary hemangiomatosis
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Functional Classification ± I PHT No limitation of activity ± II PHT Slight limitation ± III PHT Marked limitation ± IV PHT Inability to carry out any activity. ± Dyspnoea,pain,near syncope, RT HF
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Pulm HT - Current and Emerging Drugs in Pulmonary Vascular...

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