Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.1.4.1 (phosphodiesterase)
 18,767 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

High altitude pulmonary edema (HAPE) is a non-cardiogenic pulmonary edema that can occur in healthy individuals who ascend rapidly to altitudes above 3000-4000m. Excessive pulmonary artery pressure (PAP) is crucial for the development of HAPE, since lowering pulmonary artery pressure by nifedipine or tadalafil (phosphodiesterase-5-inhibitor) will in most cases prevent HAPE. Recent studies using microspheres in swine and magnetic resonance imaging in humans strongly support the concept and primacy of nonuniform hypoxic arteriolar vasoconstriction to explain how hypoxic pulmonary vasoconstriction occurring predominantly at the arteriolar level can cause leakage. Evidence is accumulating that the excessive PAP response in HAPE-susceptible individuals is due to a reduced NO bioavailability. HAPE-susceptible individuals show an endothelial dysfunction in the systemic circulation in hypoxia. Lower levels of exhaled NO in hypoxia before and during HAPE suggest that this abnormality also occurs in the lungs and polymorphisms of the eNOS gene are associated with susceptibility to HAPE in the Indian and Japanese population.
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PMID:High altitude pulmonary edema: a pressure-induced leak. 1760 98

High altitude pulmonary oedema (HAPE) is a well-known potential hazard of activities at high altitudes but not a common disease presentation that most emergency physicians have experience treating. The mainstay of treatment is intuitive--early recognition with immediate descent, rest and oxygen--but what does the emergency physician do when a patient is in severe distress from HAPE even after descent to sea level? A case of severe HAPE is presented in a young man; the successful treatment strategy is outlined including non-invasive positive pressure ventilation. The role of calcium antagonists, corticosteroids and phosphodiesterase inhibitors are also discussed in the acute management of this potentially life-threatening condition.
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PMID:Severe high altitude pulmonary oedema: a patient managed successfully with non-invasive positive pressure ventilation in the Emergency Department. 1835 70