Pulmonary hypertension: the importance of a multidisciplinary approach

In this special issue of the Netherlands Heart Journal different aspects of pulmonary hypertension are elucidated. Pulmonary hypertension (PH) is a haemodynamic state defined as a mean pulmonary artery pressure of ≥25 mmHg assessed by right heart catheterisation at rest [1]. Furthermore, PH can be divided into two main haemodynamic profiles: a pre-capillary (with a pulmonary artery wedge pressure (PAWP) ≤15 mmHg) and post-capillary form (with a PAWP >15 mmHg). Subsequently, PH can be found in different clinical conditions and is categorised into five groups based on a similar presentation, haemodynamic profile, pathological findings, and treatment: pulmonary arterial hypertension (PAH) (group 1), PH based on left heart disease (group 2), PH due to lung disease and/or hypoxaemia (group 3), chronic thromboembolic PH (CTEPH) (group 4), and PH with unclear and/or multifactorial mechanisms (group 5) [1, 2]. Patients with congenital heart disease (CHD) with a prevalent or corrected systemic-to-pulmonary shunt are at risk for the development of PAH [3]. One of the best examples of a disease associated with PH based on a multifactorial aetiology (group 5) is sarcoidosis, a rare multisystemic disorder characterised by non-caseating granulomas that can present in multiple tissues. Both preand post-capillary forms of PH might be found. In a review by Huitema et al. different aspects of PH in pulmonary sarcoidosis are de-