Treatment of Pulmonary Hypertension

00:00 How do we treat pulmonary hypertension or chronic PEs? Well the patient's hypoxic, and long-term oxygen therapy is very useful, it helps prevent progression of the disease and is also the specific treatment for patients who have got pulmonary hypertension due to cor pulmonale. The aim is to get saturations above 92% for 15 hours a day with long-term oxygen therapy. Long-term anticoagulation is the direct treatment for patients who've got pulmonary hypertension due to chronic PEs, but also is used in many patients with other causes of pulmonary hypertension because it helps slow progression. Pulmonary artery dilators such as sildenafil, prostacyclin's, calcium channel blockers, bosentan, these are very specialized treatment that are used for selective cases by specialized centers, but could be considered in patients presenting with severe pulmonary hypertension, especially the primary causes. And for those who've got chronic PEs leading to chronic thromboembolic disease and raised pulmonary artery pressures, actually surgery, thromboembolectomy can be very effective and a life changing procedure that changes patients from being hypoxic the whole time to having normal oxygens and a much better exercise tolerance. Apart from the specific situation with chronic thromboembolic disease that has been treated with surgery, unfortunately, severe pulmonary hypertension has quite a poor survival, less than five years usually, and that doesn't matter whether it's a primary disease or a secondary disease. When you get pulmonary artery pressures of 80 or 90 mmHg, then the survival of the patient is going to be of very short period.