Pulmonale Hypertonie und Rechtsherzinsuffizienz

Zusammenfassung

Pulmonale Hypertonie (PH) beschreibt einen hämodynamischen Zustand, der durch eine Druckerhöhung im kleinen Kreislauf charakterisiert ist und der insbesondere bei älteren Patienten häufig zu beobachten ist. In Abhängigkeit der Ätiologie differenziert die klinische Klassifikation der pulmonalen Hypertonie 5 Hauptgruppen. Unabhängig von der zugrunde liegenden Ursache führt eine PH zu einer chronischen Rechtsherzbelastung und Rechtsherzinsuffizienz. Aktuelle Studien zeigen, dass bereits eine moderate Erhöhung des pulmonalarteriellen Druckes sowie des pulmonalvaskulären Widerstands prognoserelevant sind. Im Einzelfall ist die konsequente differenzialdiagnostische Abklärung einer PH essenziell, da sich die Behandlungsoptionen je nach zugrunde liegender Ursache grundlegend unterscheiden.

Abstract

Pulmonary hypertension (PH) represents a hemodynamic condition, which is characterized by an elevation of pulmonary artery pressure. It is a frequent condition, particularly in elderly patients. Based on the underlying aetiology, the clinical classification of PH distinguishes five main groups. Irrespective of the underlying cause, PH represents an increased afterload for the right heart and frequently leads to right heart failure. Current studies have indicated that even moderate elevations of pulmonary artery pressure or pulmonary vascular resistance are associated with limited survival. In the individual case, a comprehensive work-up and differential diagnosis are of key importance, as the treatment modalities for the distinct forms of PH are fundamentally different.

Schlüsselwörter

pulmonale Hypertonie - Rechtsherzisuffizienz - präkapillär - postkapillär - pulmonalarterieller Druck - pulmonalvaskulärer Widerstand

Keywords

pre capillary - post capillary - pulmonary artery pressure - pulmonary vascular resistance - right heart failure - pulmonary hypertension

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