Pulmonary Hypertension: Challenges and Controversies in Diagnosis and Management

The case presentations and discussions in this issue of Advances illustrate both common and uncommon challenges in the diagnosis and management of patients with pulmonary hypertension. Although significant guidelines and evidence-based recommendations exist for patient evaluation and care, practical application of these guidelines and managing uncertainty in areas where evidence may be sparse are key elements in the daily activities of specialized pulmonary hypertension clinics.

The contributors present case-based analyses exploring important concepts and controversies in pulmonary venous hypertension, transplantation, vasoreactivity, chronic thromboembolic disease, and catastrophic antiphospholipid syndrome. Two of the cases not only illustrate important concepts but are examples of notable educational PHA initiatives: a preview of an upcoming educational CD edited by Todd Bull, MD, and a discussion from the PHCR on-line forums. As with many discussions of patient care, areas of consensus emerge, as well as topics that clearly require additional investigation.