The natural course of pregnancy causes an increase in plasma volume and cardiac output. In patients with PAH, pulmonary vascular remodeling limits the ability of the heart to handle the extra blood volume and demand, which can result in right ventricular failure and hypotension. Pregnancy in women with PAH is associated with high maternal and neonatal mortality rates. The 2015 European Society of Cardiology and European Respiratory Society (ESC/ERS) Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension recommend that women with PAH be advised against pregnancy, especially in patients with less-controlled disease. In addition, patients should be counseled on effective contraception; no recommendation has been established against the use of contraception.
Patients with PAH, especially if they are physically deconditioned, should be encouraged to participate in supervised exercise rehabilitation. Randomized trials have demonstrated that patients with PAH who reach a higher level of physical activity show improvement in exercise capacity, health status, and quality of life.
Approximately 7% of deaths in patients with PAH are due to the development of pneumonia. It is recommended that all patients receive influenza and pneumococcal pneumonia vaccinations.
Learn more about pulmonary arterial hypertension.
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Cite this: Vikramjit Khangoora. Fast Five Quiz: Pulmonary Arterial Hypertension Treatment - Medscape - Jun 02, 2022.