Vol. 13. Núm. 41.
Páginas 2359-2370 (Octubre 2021)

Actualización
Hipertensión pulmonar

Pulmonary hypertension

A. PostigoabcT. MombielaabcJ. BermejoabcF. Fernández-Avilésabc
Doi : https://10.1016/j.med.2021.09.010
Opciones
Resumen

La hipertensión pulmonar (HP) es un trastorno fisiopatológico caracterizado por un aumento de la presión de la arteria pulmonar media en reposo, que puede encontrarse asociada a numerosas entidades clínicas, condicionando un considerable aumento de su morbimortalidad. Su diagnóstico suele requerir un elevado grado de sospecha, así como un amplio número de pruebas destinadas a establecer su etiología y repercusión clínica. Para su enfoque diagnóstico y, sobre todo, terapéutico, existe una clasificación que agrupa aquellas enfermedades cuya fisiopatología, presentación clínica y características hemodinámicas son comunes, pero, especialmente, que comparten un enfoque terapéutico similar. Así, el tratamiento de la HP estará marcadamente condicionado por la entidad fisiopatológica que determine su génesis, y tendrá como objetivo aliviar los síntomas de los pacientes, retrasar la progresión de la enfermedad y mejorar su pronóstico vital. Para ello existe una amplia gama de opciones terapéuticas, desde intervenciones sobre los hábitos de vida y farmacológicas hasta procedimientos quirúrgicos o percutáneos complejos o el trasplante pulmonar.

Palabras clave
Hipertensión pulmonar
Cateterismo cardíaco
Insuficiencia cardíaca
Abstract

Pulmonary hypertension (PH) is a pathophysiological disorder characterised by an increase in mean pulmonary artery pressure at rest that can be associated with many clinical entities, thus increasing its morbidity and mortality. Diagnosis usually requires a high degree of suspicion, as well as a wide range of tests to establish aetiology and clinical repercussions. To approach the condition diagnostically and, above all, therapeutically, diseases that have pathophysiology, clinical presentation, and haemodynamic characteristics in common and, most importantly, share a similar therapeutic approach are grouped together under one classification. Thus, the management of PH will be strongly guided by the underlying pathophysiological entity and will aim to alleviate symptoms, delay disease progression, and improve the patient's prognosis. A wide range of therapeutic options are available, from lifestyle and pharmacological interventions to complex surgical or percutaneous procedures and lung transplantation.

Keywords
Pulmonary hypertension
Cardiac catheterisation
Heart failure

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