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19. Pulmonary Hypertension Explained: High-Yield Pulmonology for NEET PG, FMGE & USMLE Aspirants! 🫀

Pulmonary Hypertension (PH) is a complex and progressive condition characterized by elevated blood pressure in the pulmonary arteries, leading to increased workload on the right side of the heart and potentially resulting in right heart failure. PH is classified into five groups based on etiology:

Group 1: Pulmonary Arterial Hypertension (PAH) – idiopathic, heritable, drug-induced, or associated with conditions like connective tissue diseases and HIV.

Group 2: PH due to left heart disease – including left ventricular systolic or diastolic dysfunction and valvular diseases.

Group 3: PH due to lung diseases or hypoxia – such as COPD, interstitial lung disease, and sleep apnea.

Group 4: Chronic thromboembolic PH (CTEPH) – resulting from unresolved pulmonary emboli.

Group 5: PH with unclear multifactorial mechanisms – including hematologic, systemic, and metabolic disorders.

Clinically, patients may present with nonspecific symptoms like dyspnea on exertion, fatigue, chest pain, syncope, and peripheral edema. Diagnostic evaluation involves echocardiography, right heart catheterization (gold standard), chest imaging, pulmonary function tests, and laboratory studies to determine the underlying cause. Management strategies vary based on the PH group and may include vasodilator therapies (e.g., endothelin receptor antagonists, phosphodiesterase-5 inhibitors), anticoagulation, oxygen therapy, diuretics, and in advanced cases, lung transplantation.

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