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population (average age of 50 years) when compared with the more common thoracic organ diseases such as coronary artery disease and chronic obstructive lung disease. PAH in adults includes at least nine clinical subgroups with virtually identical obstructive pathologic changes (Figures 1 and 2) in the distal pul- monary arteries: idiopathic, heritable, drug- and toxin-induced, associated with, connective tissue diseases, HIV infection, portal hypertension, congenital heart disease, schistosomiasis, and chronic haemolytic anaemia. 1

Pulmonary arterial hypertension: from the kingdom of the near-dead to multiple clinical trial meta-analyses