Management of Crashing Patients with Pulmonary Hypertension

John C Greenwood; Ryan M Spangler

doi:10.1016/j.emc.2015.04.012

Management of Crashing Patients with Pulmonary Hypertension

Emerg Med Clin North Am. 2015 Aug;33(3):623-43. doi: 10.1016/j.emc.2015.04.012. Epub 2015 Jun 6.

Authors

John C Greenwood¹, Ryan M Spangler²

Affiliations

¹ Department of Emergency Medicine, Ground floor, Ravdin Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address: johncgreenwood@gmail.com.
² Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Baltimore, MD 21201, USA.

PMID: 26226870
DOI: 10.1016/j.emc.2015.04.012

Abstract

Critically ill patients with pulmonary hypertension (PH) often seem well, but they can decompensate dramatically in a short time. PH has several causes, classes, and complications; but the natural progression eventually leads to right ventricular failure, which can be extraordinarily difficult to manage. The purpose of this review is to discuss the causes, signs, and symptoms of PH as well as its management strategies and emergent complications. Treatment options are often limited, so it is imperative that the emergency department physician can recognize and manage these patients in a timely fashion.

Keywords: Cardiogenic shock; Pulmonary hypertension; Right ventricular failure.

Publication types

Review

MeSH terms

Blood Volume / physiology
Disease Management
Electrocardiography / methods
Heart Failure / complications
Heart Failure / diagnosis
Heart Failure / physiopathology
Heart Failure / therapy*
Humans
Hypertension, Pulmonary / complications
Hypertension, Pulmonary / diagnosis*
Hypertension, Pulmonary / therapy*
Radiography, Thoracic / methods
Resuscitation / methods*
Ventricular Dysfunction, Right