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Primary Pulmonary Hypertension: More Light or More Tunnel?

ALFRED P. FISHMAN, M.D.
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Cardiovascular-Pulmonary Division, Hospital of the University of Pennsylvania; Philadelphia, Pennsylvania


Ann Intern Med. 1981;94(6):815-817. doi:10.7326/0003-4819-94-6-815
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The designation "primary pulmonary hypertension" refers to an aggregate of disorders with a remarkably uniform clinical picture, even though the initiating and subsequent pathogenetic mechanisms may be quite different. The clinical picture is characterized by evidence of pulmonary hypertension in association with progressive exercise intolerance caused by easy fatigability, undue breathlessness, chest pain, or syncope. Unfortunately, an increase in pulmonary arterial pressure is difficult to detect clinically at an early stage. On the other hand, in the later stages, after characteristic roentgenographic and electrocardiographic changes have occurred, it is often difficult to decide whether the disease is really primary or

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