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Updated Hemodynamic Definition
- Pulmonary hypertension is now defined as mean PA pressure >20 mmHg or PVR >3 Wood units.
- The prior threshold was mPAP ≥25 mmHg, lowering the bar increases sensitivity for earlier disease.
Pre- vs Post-Capillary Physiology
- Separate pre-capillary and post-capillary physiology by where resistance originates in the pulmonary circuit.
- Pre-capillary disease arises before capillaries (pulmonary arteries); post-capillary reflects left-heart/venous congestion.
Targeted History For Suspected PH
- When evaluating unexplained dyspnea ask timing, exertional vs rest, cough, orthopnea, leg swelling, and connective-tissue symptoms.
- Screen for liver disease, thyroid disease, HIV, rheumatologic signs, and family history to identify causes.