Unexplained pulmonary hypertension in older patients: Clinical characteristics, follow-up, and prognosis

M. Yigla, Z. Azzam, D. Rinkevich, A. H.E. Rubin, S. A. Reisner

    Research output: Contribution to journalArticle

    1 Scopus citations

    Abstract

    The clinical characteristics, follow-up and prognosis of unexplained pulmonary hypertension (UPHT) in 8 older patients, age at diagnosis 62.5 ± 11.6 years (Mean ± 1 SD, range 51 to 82), were evaluated. Seven of the patients were women. Systolic pulmonary artery pressure (PAP) at diagnosis was 87 ± 10 mm Hg (Mean ± 1 SD, range 70 to 100). A majority of the patients (7/8) had advanced disease at diagnosis (New York Heart Association classes 3 and 4) with right heart failure (RHF) as the presenting symptom in 6 of the 8 patients (75%). Following treatment with calcium channel blockers, diuretics, oxygen and anticoagulants, functional capacity and symptoms of RHF, but not PAP, improved in 4 patients (50%). These patients are alive 37 ± 11 months (Mean ± 1 SD, range 23 to 53) after diagnosis. Four patients died after a mean follow-up of 6.8 ± 7.6 months (Mean ± 1 SD, range 2 to 18). One of these patients died suddenly and another 3 died with intractable RHF. Our study shows that most newly diagnosed older patients with UPHT in our institute were women. RHF at diagnosis, a sign that indicates a poor prognosis in younger patients with UPHT, is common in older patients with UPHT and was not associated with a particularly poor prognosis. Clinical response to medical treatment, rather than PAP changes, was associated with improved outcome.

    Original languageEnglish (US)
    Pages (from-to)9-15
    Number of pages7
    JournalJournal of Cardiovascular Diagnosis and Procedures
    Volume14
    Issue number1
    StatePublished - Jan 1 1997

    ASJC Scopus subject areas

    • Medicine (miscellaneous)
    • Cardiology and Cardiovascular Medicine

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