Pulmonary hypertension: the state of the art

Pulmonary hypertension (PH) is a hemodynamic and pathophysiological condition defined as an increase in mean pulmonary arterial pressure of 25 mmHg or more at rest assessed by right heart catheterisation. It is a progressive disease characterized by high mortality and morbidity. Current PH guidelines suggest that patients with PH should be cared for in dedicated specialist centres, with expertise and resources available to provide high quality care to this fragile population. In this review, we focus on the clinical manifestations, diagnostic algorithm, risk assessment and therapeutic strategies for PH. We also provide an overview of the organisation of PH services in United Kingdom, including designation of expert centres, national audit and steps to ensure the quality and financial viability of PH care.