Complications
Pulmonary vascular narrowing causes a progressive increase in pulmonary vascular resistance, which leads to right ventricular overload and eventually to right ventricular failure and death.[3] Treatment includes diuretics, digoxin, oxygen supplementation, oral pulmonary vasodilator therapy, and parenteral therapies.[3]
Seen in 11% of patients with severe pulmonary hypertension in association with right ventricular failure.[103] They are probably related to structural changes and enlargement of the right ventricle and the right atrium secondary to chronic pressure overload.
Treatment options include digoxin, electrical cardioversion, overdrive pacing, and radiofrequency ablation.
Prostanoids, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors cause headache as an adverse effect.
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Patients receiving prostanoids via a central venous catheter are prone to bloodstream infections, which must be recognised and treated promptly. Detailed guidelines for the prevention of catheter-related complications in these patients have been published.[104]
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