Hypercoagulability in Pulmonary Hypertension

Isabel S Bazan; Wassim H Fares

doi:10.1016/j.ccm.2018.04.005

Hypercoagulability in Pulmonary Hypertension

Clin Chest Med. 2018 Sep;39(3):595-603. doi: 10.1016/j.ccm.2018.04.005.

Authors

Isabel S Bazan¹, Wassim H Fares²

Affiliations

¹ Section of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA. Electronic address: isabel.bazan@yale.edu.
² Section of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA.

PMID: 30122183
DOI: 10.1016/j.ccm.2018.04.005

Abstract

Pulmonary hypertension (PH) is divided into varied pathophysiological and etiologic groupings, as classified by the World Health Organization (WHO). Pulmonary arterial hypertension (PAH), which falls under WHO group 1 PH, is a progressive and potentially fatal disease characterized by a vasoconstrictive, proliferative, and thrombotic phenotype, which leads to increased pulmonary artery pressure, right heart failure, and death. Pathologically, in situ thromboses are found in the small distal pulmonary arteries. Dysregulation of coagulation, platelet function, and endothelial cells may contribute to a prothrombotic state. There is mixed evidence for the use of anticoagulation or antiplatelet therapy in PAH patients.

Keywords: Anticoagulation; Hypercoagulability; Pulmonary arterial hypertension; Pulmonary embolism; Pulmonary hypertension; Right heart failure; Right ventricle; Thromboembolism.

Publication types

Review

MeSH terms

Humans
Hypertension, Pulmonary / complications*
Hypertension, Pulmonary / pathology
Thrombophilia / diagnosis*
Thrombophilia / pathology