Pulmonell hypertension vanligt vid kronisk lungsjukdom

In 2015 the European Society of Cardiology and European Respiratory Society published new guidelines on the diagnosis and treatment of pulmonary hypertension (PH). PH due to lung diseases and/ or hypoxia was classified as a separate entity. PH is common in lung diseases, but seldom severe. Nevertheless, the presence of PH in a patient with lung disease is associated with worse outcome. If there is clinical suspicion of PH in a patient with lung disease, echocardiography is recommended, and if there are signs of severe PH and/or severe right ventricular dysfunction the patient should be referred to a PH expert centre. Patients may have lung disease and e.g. pulmonary arterial hypertension or chronic thromboembolic PH simultaneously, and targeted treatments are available in such cases. PH-targeted drugs should, however, not be used to treat PH due to lung diseases, since there are no robust data speaking for their benefit and a risk of impaired arterial oxygenation due to inhibition of hypoxic pulmonary vasoconstriction. Instead, the underlying lung disease should be optimally treated, including long-term oxygen therapy in case of chronic hypoxemia.