Pulmonary Hypertension: Therapy

General measures

  • Presentation of the patient to a specialized PH center in cases of suspected PAH and evidence of severe PH associated with left heart or lung disease, among others.
  • Pregnancy should be avoided.
  • Travel recommendations:
    • No travel at altitudes > 2,000 m
    • No hot or humid climate
    • Short flights; long flights can lead to dehydration (lack of fluids), peripheral edema (water retention), and thrombosis (formation of blood clots)
    • Requirement for fitness to fly: oxygen saturation (SpO2) should be at least 85 percent, pO2 70 mmHg, ventilation capacity 3 l and FEV1 at least 70 percent.

Conventional non-surgical therapy methods

In patients associated with chronic hypoxia/oxygen deficiency (chronic hypoxemia at rest: arterial partial pressure of oxygen (pO2) < 55 mmHg), long-term oxygen therapy (LTOT; 16-24 h/d) is indicated. Enough oxygen should be given to raise the pO2 to about 60-70 mmHg.

Humidifiers can be used at flow rates of 2 liters/minute and above.The minimum duration of use for long-term oxygen therapy should be 15 hours daily.

The therapy provides adequate oxygen to the tissues and relieves the respiratory muscles.

Patients receiving LTOT should be followed up regularly.

Vaccinations

The following vaccinations are advised, as infection can often lead to worsening of the presenting disease:

  • Pneumococcal vaccination
  • Flu vaccination

Regular checkups

  • Regular medical checkups

Sports medicine

  • Light endurance training (cardio training).
  • Physical overexertion should be avoided to prevent right heart overload. However, targeted training using a cycle ergometer (low-dose) is thought to have positive effects. Cautious, closely monitored breathing and exercise therapy showed a positive effect on exercise tolerance and quality of life in a randomized controlled trial.
  • Creation of a fitness plan with appropriate sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Physical therapy (including physiotherapy)

  • Active physical therapy to improve exercise tolerance and cardiac function.
  • Specific respiratory and exercise therapy with individualized exercise intensity as well as exercise frequency.

Psychotherapy