Table 1—

World Health Organization diagnostic classification

Pulmonary arterial hypertension
 Primary pulmonary hypertension
  Sporadic
  Familial
 Related to:
 Collagen vascular disease
 Congenital systemic to pulmonary shunts
 Portal hypertension
 HIV infection
 Drugs/toxins
  Anorexigens
  Other
 Persistent pulmonary hypertension of the newborn
 Other
Pulmonary venous hypertension
 Left-sided atrial or ventricular heart disease
 Left-sided valvular heart disease
 Extrinsic compression of central pulmonary veins
  Fibrosing mediastinitis
  Adenopathy/tumours
 Pulmonary veno-occlusive disease
 Other
Pulmonary hypertension associated with disorders of the respiratory system and/or hypoxaemia
 Chronic obstructive pulmonary disease
 Interstitial lung disease
 Sleep-disordered breathing
 Alveolar hypoventilation disorders
 Chronic exposure to high altitude
 Neonatal lung disease
 Alveolar-capillary dysplasia
 Other
Pulmonary hypertension due to chronic thrombotic and/or embolic disease
 Thromboembolic obstruction of proximal pulmonary arteries
 Obstruction of distal pulmonary arteries
  Pulmonary embolism (thrombus, tumour, ova and/or parasites, foreign material)
  In situ thrombosis
  Sickle cell disease
Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature
 Inflammatory
  Schistosomiasis
  Sarcoidosis
  Other
 Pulmonary capillary haemangiomatosis
  • Although this clinical classification is primarily concerned with causes and thus prevention and treatment, the classification is in keeping with the pathological characterisation of pulmonary hypertensive states

  • Pulmonary hypertension (PH) that results from identifiable causes (secondary PH) is far more common than pulmonary hypertension with no apparent cause (primary PH)

  • HIV: human immunodeficiency virus