PT - JOURNAL ARTICLE AU - D. Montani AU - D. S. O'Callaghan AU - X. Jaïs AU - L. Savale AU - D. Natali AU - A. Redzepi AU - S. Hoette AU - F. Parent AU - O. Sitbon AU - G. Simonneau AU - M. Humbert TI - Implementing the ESC/ERS pulmonary hypertension guidelines: real-life cases from a national referral centre AID - 10.1183/09059180.00005909 DP - 2009 Dec 01 TA - European Respiratory Review PG - 272--290 VI - 18 IP - 114 4099 - http://err.ersjournals.com/content/18/114/272.short 4100 - http://err.ersjournals.com/content/18/114/272.full SO - EUROPEAN RESPIRATORY REVIEW2009 Dec 01; 18 AB - Pulmonary hypertension (PH) comprises a heterogeneous group of disorders characterised by increased pulmonary vascular resistance that results in progressive right ventricular failure. In order to translate current evidence into routine clinical practice, the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) have recently jointly proposed evidence-based guidelines for the optimal management of different PH patient groups. This article describes a series of clinical cases of PH due to various aetiologies that were referred to a large national PH expert referral centre. In each case, the assessment and therapeutic approach undertaken is described in the context of the new ECS/ERS guidelines. The routine diagnostic work-up of suspected idiopathic pulmonary arterial hypertension (PAH) and recommended treatments for patients with functional class II, III and IV disease is emphasised. Familial screening and management of heritable PAH is discussed. Appropriate investigation and therapeutic strategies for patients with chronic thromboembolic disease and PH that is associated with congenital heart disease, pulmonary veno-occlusive disease and systemic sclerosis are also highlighted.