11th May 2025

Complications

Right heart failure – the most common and ultimately inevitable complication of PH is right cardiac failure. Raised pulmonary pressures effectively ‘obstruct’ the right outflow tract and so increase afterload of the right heart, this in turn causes right sided cardiac hypertrophy and failure.
Supraventricular tachyarrhythmias – right sided heart failure may lead to right atrial dilatation, which can predispose patients to atrial fibrillation and atrial flutter
Pneumonia – patients with PH are at greater risk of developing pneumonia and is associated with the mortality of this patient group.
Mortality – historically, prior to development in management of PH mortality was high, with an untreated median survival was 2.8 years. Since the introduction of targeted therapies, 3-year survival has risen to 87%
Pregnancy mortality – pregnancy is associated with a high maternal mortality (17-33%) and should be avoided.
Treatment related side effects – prostanoids, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors all commonly cause headache as an adverse side effect.

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