• Charles J Fox, Elyse M Cornett, Brendon M Hart, Aaron J Kaye, Shilpadevi S Patil, Michelle Carroll Turpin, Angelica Valdez, Richard D Urman, and Alan D Kaye.
• Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Electronic address: cfox1@lsuhsc.edu.
• Best Pract Res Clin Anaesthesiol. 2018 Jun 1; 32 (2): 237-250.

AbstractNumerous conditions give rise to pulmonary arterial hypertension (PAH), with most of them being idiopathic. Signs and symptoms are generally difficult to recognize initially because they present as nonspecific and typically are mistaken for age-related physiological processes or alternate medical conditions. Many advances have been made toward PAH-specific therapies that have led to advanced clinical management of the disease. The present investigation describes new pulmonary vasodilator agents that are currently available or under development that could impact perioperative management. The 6-min walk test is the gold standard in assessing the efficacy of any pulmonary hypertension treatment, and the only drug to show any mortality benefit in pulmonary hypertension is epoprostenol. The present investigation also describes the latest evidence on using these medications in the perioperative period, including clinical trials and practice guidelines. Future direction for research and clinical management of pulmonary hypertension is described.Copyright © 2018 Elsevier Ltd. All rights reserved.

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