Highlights the variable pulmonary vascular responses and mechanisms of pulmonary hypertension in severe mitral stenosis.
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Variable pulmonary vascular responses in severe mitral stenosis warrant individualized PH evaluation; leaves open targeted therapeutic strategies.
Some degree of pulmonary hypertension is an invariable accompaniment of severe mitral-valve disease and is apparently due to initiation of reflex changes within the pulmonary resistance vessels by retrograde transmission of the elevated left atrial pressure. In some patients the rise in pulmonary-artery pressure is sufficient only to maintain the normal pressure differential across the pulmonary vascular bed; in others there is a disproportionate increase in pulmonary artery pressure, which may approach or exceed systemic blood pressure. In either case the mechanism through which these changes take place is unknown. Although it was initially thought that anatomic changes within the . . .
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Otero et al. (1967) studied this question.
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