Abstract
Pulmonary hypertension is involved in the development of various diseases and therefore it can be caused by several mechanisms from a simple pressure elevation in the pulmonary artery to the serious impairments of pulmonary vessels. The algorism of pharmacotherapy results from the test of acute pulmonary vasodilation.
Only the patients with positive test are indicated to the treatment with high doses of calcium channel blockers. Patients with negative test receive beside the chronic anticoagulation therapy also a specific pharmacotherapy (prostanoids, antagonists of endotheline receptors, etc) with not only vasodilatory but also with antiproliferative and antiaggregatory effects.
When all possibilities of pharmacotherapy are exhausted, balloon atrial septostomy or lung transplantation should be considered. Method of choice in the treatment of chronic thromboembolic pulmonary hypertension is the pulmonary endarterectomy in patients with surgically curable thrombotic obstruction.