ABSTRACT
The heart can be adversely affected by both parenchymal lung disease and disease pro cesses that primarily affect the pulmonary vasculature. While hypoxemia secondary to lung disease can adversely affect left ventricular function, lung disease that causes heart disease invariably does so through an increase in pulmonary artery pressure, which then causes right heart dysfunction. The pathophysiology and clinical manifestations of pulmo nary hypertension are often poorly understood. Since pulmonary hypertension is central to the pathophysiology of heart disease caused by lung disease, this chapter focuses primar ily on pulmonary hypertension with an emphasis on pathophysiology and clinical manifes tations. This chapter does not focus on the specifics of interstitial or airway lung disease. Instead, the reader is referred to other chapters in this book for discussions of the patho physiology of specific parenchymal lung diseases. Thromboembolism should be consid ered in all patients with pulmonary artery hypertension. For a detailed review, the reader is referred to Chap. 30, on thromboembolism.
