Nonpharmacological management of pulmonary arterial hypertension

Besides standard medical care, PAH management should be implemented with supportive therapies, including promotion of physical activity and healthy lifestyle, fluid restriction, nutritional advice, oxygen therapy, consideration of iron supplementation when needed, psychological support and encouraging vaccinations in patients. Given the fragile equilibrium of PAH patients, addressing all the different aspects of this disease, alongside with the administration of targeted PAH therapies, is pivotal not only to enhance clinical outcome but also to improve quality of life. Furthermore, it is essential to address possible cardiovascular comorbidities with the appropriate medical treatment, considering the peculiar and specific characteristics of each PAH patient. Finally, selected patients might benefit from interventional and surgical procedures, such as atrial septostomy, Potts shunts and pulmonary artery denervation, which might reduce symptoms of advanced right heart failure.