View source for Eisenmenger’s syndrome ACC/AHA guidelines for evaluation of patients

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'''Associate Editor-In-Chief:''' [[Priyamvada Singh|Priyamavada Singh, MBBS]] [[mailto:psingh@perfuse.org]] '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [[mailto:kfeeney@perfuse.org]]

==Overview==

==ACC / AHA 2008 Guidelines- Recommendations for Evaluation of the Patient With Congenital Heart Disease– Pulmonary Arterial Hypertension (DO NOT EDIT)==

{| class="wikitable"
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Care of adult patients with CHD-related PAH should be performed in centers that have shared expertise and training in both ACHD and PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>

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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' The evaluation of all ACHD patients with suspected PAH should include noninvasive assessment of cardiovascular anatomy and potential shunting, as detailed below:

a. Pulse oximetry, with and without administration of supplemental oxygen, as appropriate. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' 

b. Chest x-ray. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''

c. ECG. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' 

d. Diagnostic cardiovascular imaging via TTE, TEE, MRI, or CT as appropriate. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' 

e. Complete blood count and nuclear lung scintigraphy. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>

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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' If PAH is identified but its causes are not fully recognized, additional testing should include the following:

a. Pulmonary function tests with volumes and diffusion capacity (diffusing capacity of the lung for carbon monoxide). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' 

b. Pulmonary embolism–protocol CT with parenchymal lung windows. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' 
c. Additional testing as appropriate to rule out contributing causes of PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' 

d. Cardiac catheterization at least once, with potential for vasodilator testing or anatomic intervention, at a center with expertise in catheterization, PAH, and management of CHD-PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>

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{| class="wikitable"
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
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| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' It is reasonable to include a 6-minute walk test or similar nonmaximal cardiopulmonary exercise test as part of the functional assessment of patients with CHD-PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>

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==References==
{{reflist|2}}

[[Category:Cardiology]]
[[Category:Congenital heart disease]]
[[Category:Pediatrics]]
[[Category:Disease]]