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VascularCurrent Guideline Must Read⚡ High-Yield Board Topic

2022 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension

Humbert M, Kovacs G, Hoeper MM et al.·European Heart Journal·2022· DOI: 10.1093/eurheartj/ehac237
PAHPulmonary HypertensionESCERSGuidelinesRisk StratificationClassification
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AI-Generated Summary

Educational summary — always verify with primary source
Background

The 2022 ESC/ERS PH guideline is the most comprehensive update to PH classification, diagnosis, and management, replacing the 2015 guideline.

Study Design

Evidence-based guideline by ESC/ERS expert panel.

Key Findings

Key updates: (1) Updated hemodynamic definition: mPAP >20 mmHg (was >25); (2) PVR threshold: >2 WU (was >3); (3) Updated risk stratification tool (4-strata: low/intermediate-low/intermediate-high/high); (4) Sotatercept added after STELLAR; (5) Upfront triple therapy for high-risk PAH; (6) Updated Group 3 (lung disease) and Group 4 (CTEPH) management.

Clinical Bottom Line

Know the updated hemodynamic definition (mPAP >20, PVR >2 WU), the 5-group PH classification, and risk stratification. The 2022 guideline lowered the mPAP threshold — this will appear on boards. CTEPH = surgical endarterectomy if operable.

Limitations & Caveats

Guideline — some recommendations based on expert consensus. Updated hemodynamic definition may increase PAH diagnosis rates.

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