There are many causes of
PH. Sorting out (also known as classifying)
and labeling different types of PH is very
important for many reasons:
- It helps doctors
and scientists communicate better
- It helps doctors understand
how different types of PH are related
- It helps
doctors make a clearer diagnosis of PH
- It makes the treatment of
PH clearer
- It helps doctors better
understand how a patient might respond
to a treatment
In the past, PH was simply classified into
primary or secondary:
- Primary PH (PPH). An
older term. In a small number of PH patients,
there is no
known cause
for PH. These patients were said to have
PPH. In the current 2003 Venice classification,
these patients would be diagnosed with
idiopathic PAH (IPAH)
- Secondary PH (SPH).
An older term. SPH indicated
that there was a known cause for PH,
such as heart disease (for example, heart
failure),
lung disease (for example, emphysema),
or a general medical condition (such as cirrhosis
of the liver)
The most commonly used classification system
today is the 2003 World Health Organization
(WHO) Venice PH Classification System. Groups
in the 2003 Venice classification system include:
- WHO Group 1: PAH = pulmonary arterial hypertension.
A newer term, which specifically
indicates
that PH is due to narrowing of the pulmonary
arteries of the lungs. PAH is a broad category
which includes many patients with different
types of PAH:
- IPAH = idiopathic PAH. A
newer term for the old term, PPH. In
a small number of
PH patients,
there is no known cause for PH. They
are said to have IPAH
- FPAH = familial
PAH. In some PAH patients, PAH was
inherited
from their parents.
There is often a history of PAH
in other close
members of the patient’s
family (for example, parents, sibilings,
or
children)
- CTD-PAH. PAH associated with
connective tissue disease (CTD),
such as scleroderma
- HIV-PAH. PAH associated
with HIV infection
- CHD-PAH. PAH due to heart
defects present at birth (also known
as congenital heart
disease = CHD)
- WHO Group II: PVH
= pulmonary venous hypertension. PH due
to disease of the left-side
of the heart, including the left ventricle
(LV; lower left chamber) of the heart, left
atrium (LA; upper left chamber), or disease
of the mitral valve or aortic valve on the
left-side of the heart
- WHO Group III: PH due
to pulmonary arteries being blocked by
blood clots (also
known as pulmonary embolism). This type of
PH is often referred to as chronic thromboembolic
PH (CTEPH). In rare patients, PH can be due
to other types of material blocking pulmonary
arteries, including cancer cells or eggs
of the parasite infection, schistosomiasis.
- WHO Group IV: PH due to lung disease and
low blood oxygen levels. These lung diseases
include emphysema of the lung (usually due
to smoking), scarring (also known as fibrosis)
of the lung, or breathing problems during
sleep (for example, sleep apnea)
- WHO Group
V: PH due to various other rare lung conditions
and other rare general
medical conditions