Analysis of the 2022 European Society of Cardiology/European Respiratory Society Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension

Pulmonary hypertension (PH) is a significantly challenging pathophysiology in the perioperative period, as it often results in both end-stage heart and lung disease. While the precise prevalence of PH in the population presenting for major non-cardiac surgery is unknown, its impact is significant in terms of increased perioperative adverse cardiovascular events and mortality.1 A suspected patient with PH often presents with decreased functional capacity, which is a subjective clinical symptom consistent with objective worsening of symptoms and predictive of poor perioperative outcomes.2 A thorough evaluation of a patient with PH includes the deployment of a high-risk multidisciplinary team, the benefits of which have been discussed in previous studies of similar high-risk disease processes3 as well as the latest European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines.4, 5 In this review, we aim to outline the major recommendations from the new ESC/ERS guidelines, highlight the changes from the prior guidelines and provide a brief overview of the literature that supports the recommendations.