Description
Pulmonary arterial hypertension, an uncommon but all too frequently fatal condition, represents one of those niche areas of medicine that attracts a small but fanatical following of experts. Such fanaticism is matched by the pharmaceutical companies who are able to leverage enormous profits from the successful treatment from a relatively small number of treated patients. It would be easy to become cynical about the symbiotic relationship between the experts and industry in pulmonary arterial hypertension but for one thing – improved awareness and treatment, leading to better health outcomes for those unfortunate (predominantly young women) to be affected.
As an ‘outsider’ who dabbled on the edges of pulmonary arterial hypertension, I have been more than fortunate to meet and talk to many of the experts who have put pulmonary arterial hypertension on the map and pioneered the significant therapeutic strides outlined in this book and its first incarnation (Simon Stewart, Pulmonary Arterial Hypertension: A Pocketbook Guide (2005), Taylor & Francis, London & New York). In publishing this new improved version of the book, I have been able to correct one important injustice done to one of the ‘hidden’ experts in pulmonary arterial hypertension – my co-author Geoff Strange. Suffering from his links to the pharmaceutical industry, Geoff was unwilling to come on board as a co-author of the first book; even though he richly deserved this position given his expert and impartial contribution. Thanks to the success of the first book, I’m delighted that we now have the opportunity to publish a second book that recognizes his expertise and co-authorship!
My aim in initiating and (co-)writing these two books was very simple: to introduce the wider health community to the importance of detecting potentially hidden pulmonary arterial hypertension and sending those unfortunate to be affected into the fanatical and passionate care routinely offered by expert centres. It is only through a united effort between the wider health community and the experts that we can positively alter the still fatal natural history of pulmonary arterial hypertension.
I hope this book achieves its aim and provides you with a succinct and invaluable overview of pulmonary arterial hypertension. Perhaps, one day, it will prompt you to suspect the presence of pulmonary arterial hypertension and save the life of an individual who would die prematurely without expert care and treatment.
Simon Stewart
Contents
Preface vii
1. Introduction 1
2. Disease background and epidemiology of pulmonary arterial hypertension 5
3. Pulmonary arterial hypertension – increasing our understanding of disease pathophysiology 13
4. Pulmonary arterial hypertension – clinical profile and diagnosis 21
5. Improving outcomes in pulmonary arterial hypertension – pharmacological and surgical treatment strategies 29
6. Screening and management of pulmonary arterial hypertension 41
APPENDIX
Informative websites: pulmonary arterial hypertension 47
References 49
Index 59