Pulmonell hypertension
Senast uppdaterad: Senast reviderad:
Sakkunnig:Anna Nager
Definition:
Definieras som ökat genomsnittligt vilotryck i arteria pulmonalis (MAP) ≥25 mmHg. Kan ha idiopatisk grund eller vara komplikation till en rad olika sjukdomar såsom hjärtsvikt, kroniska lungsjukdomar och bindvävssjukdomar.
Förekomst:
Ses oftast kliniskt vid symtomatisk vänstersidig hjärtsvikt. Den idiopatiska formen är sällsynt med en incidens på 1–2/1 000 000 årligen.
Symtom:
Dyspné, trötthet, synkope. Eventuella symtom på underliggande sjukdom.
Kliniska fynd:
Eventuellt cyanos. EKG-förändringar förenliga med högersidig belastning. Eventuellt ödem, hepatomegali och halsvenstas vid högersidig svikt.
Diagnostik:
Diagnosen ställs med hjärtkateterisering med tryckmätning, eventuellt med ekokardiografi.
Behandling:
Hjärtsviktsbehandling. Eventuellt vasodilaterande behandling vid idiopatisk form. Eventuellt lungtransplantation.
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- Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet
Tidigare sakkunniga
- Karl Swedberg, senior professor och överläkare, Enheten för akut och kardiovaskulär medicin, Institutionen för medicin, Sahlgrenska Akademin, Göteborg