Early identification and intervention of PAH
Early diagnosis and therapeutic intervention may offer improved outlook for patients. Prognosis and response to treatment have both been shown to be better for patients in less severe WHO functional class (WHO FC) compared with those who do not begin targeted therapy until their Pulmonary Arterial Hypertension (PAH) is in a more severe stage (ie, WHO FC III/IV)1 (see section, ‘Assessing the severity of PAH'  ).
By recognising and treating patients as early as possible, disease progression may be delayed. However, this poses a challenge to healthcare professionals because many of the initial symptoms of Pulmonary Arterial Hypertension (PAH) - breathlessness, chest tightness and fatigue - are mild and non-specific and so many patients are diagnosed when their disease is already quite severe.2 Although the mean time from onset to diagnosis is estimated to be approximately two years,2 different patients will progress at different rates, which depend on various factors (see section, ‘How is PAH diagnosed?' ) . This makes it even more important to diagnose early.
References
1. Sitbon O, Humbert M, Nunes H, et al. Long-term intravenous epoprostenol infusion in primary pulmonary hypertension: prognostic factors and survival. J Am Coll Cardiol 2002;40:780-788.
2. Humbert M, Sitbon O, Chaouat A, et al. Pulmonary arterial hypertension in France: results from a national registry. Am.J.Respir.Crit Care Med. 2006;173:1023-1030.
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