If I hadnt blacked out

Summary

Clinically important PH is common in patients with chronic HF. The optimal approach to these patients is uncertain and therefore must be individualized. When the PH is felt to be in proportion to the HF, therapy is generally focused exclusively on the HF. One exception is the patient with PH and advanced HF for whom mechanical circulatory support or cardiac transplantation is being considered. In this setting PAH-specific therapies may be a useful adjunct, possibly allowing for the potentially curative procedure to be attempted. When the PH is felt to be out of proportion to the HF, initial efforts are again focused on the HF. If the PH (and the symptoms potentially related to it) persists, and the PCWP is maintained in an acceptable range, the use of PAH-specific therapies may be considered. Caution must be used, however, because these agents may precipitate fluid retention and pulmonary edema in patients with HF. Whereas initial studies of PAH-specific therapies were discouraging, more recent ones have suggested promise. The results of several planned or ongoing trials in this area will undoubtedly lend clarity to this challenging clinical question. While awaiting those results, consensus statements from experts in the field will be forthcoming and should provide more guidance.

This activity is supported by an independent educational grant from Actelion.  Printer- Friendly Email ThisAcknowledgements

The author would like to thank Drs. Myung Park and Jeffrey Teuteberg for their critical reviews and suggestions.

Medscape Pulmonary Medicine.  2008; ©2008 Medscape
This is a part of article Pulmonary Hypertension in Heart Failure Taken from "Sildenafil Citrate Generic" Information Blog

Labels: pharmacology

# posted by Wei Ella @ 4:48 AM