milrinone pulmonary hypertension

Milrinone, a phosphodiesterase inhibitor, is primarily indicated for the management of heart failure. However, there is a potential association between its use and pulmonary arterial hypertension (PAH), a serious pulmonary vascular condition that can result in right ventricular hypertrophy and heart failure.

The mechanism by which milrinone might contribute to PAH could be attributed to its effects on pulmonary vasculature. By increasing intracellular levels of cyclic adenosine monophosphate (cAMP), milrinone promotes vasodilation and reduces blood pressure. Yet, in certain instances, this vasodilatory effect could lead to excessive dilation of the pulmonary vessels, consequently elevating pulmonary arterial pressure. Milrinone may also impact pulmonary vasculature through additional mechanisms, such as altering the structure and function of the vascular wall.

Consequently, it is imperative to regularly monitor pulmonary arterial pressure in patients undergoing milrinone therapy and to seek immediate medical attention if symptoms of PAH emerge. Patients should adhere to their physician's recommendations regarding medication use, avoiding any self-adjustment of dosages or discontinuation of the drug. Furthermore, during treatment, patients should focus on lifestyle modifications, including smoking cessation, sodium restriction, and engaging in appropriate physical activity, to assist in managing their condition.