Secondary pulmonary hypertension is seen in disorders that either interfere with gas exchange within the lung or in which large portions of the pulmonary vasculature are obliterated. Because the causes are diverse, there is no uniform approach to therapy. The approach to treatment should be methodic, but aggressive and primarily directed at improving the underlying disease process. Other forms of therapy, which are more controversial, should be reserved for patients with refractory cor pulmonale and should be instituted cautiously and their effects monitored closely.
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