Pulmonary hypertension screening: Difference between revisions
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* Studies have not shown impact on outcomes with [[pulmonary hypertension]] [[screening]]; | * Studies have not shown impact on outcomes with [[pulmonary hypertension]] [[screening]]; | ||
* Despite that, it is expert consensus that some groups of patients must be screened for [[pulmonary hypertension]] such as: | * Despite that, it is expert consensus that some groups of patients must be screened for [[pulmonary hypertension]] such as: | ||
**Patients with [[scleroderma]] spectrum disorders | **Patients with [[scleroderma]] spectrum disorders (especially the ones with corrected DLCO less than 80%); | ||
**Patients with mutations for a heritable form of [[PAH]]; | **Patients with mutations for a heritable form of [[PAH]]; | ||
* These patients must be screened annually with [[echocardiography]]. | * These patients must be screened annually with [[echocardiography]]. | ||
Revision as of 18:44, 26 April 2021
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Pulmonary Hypertension Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Pulmonary hypertension screening On the Web |
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American Roentgen Ray Society Images of Pulmonary hypertension screening |
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Risk calculators and risk factors for Pulmonary hypertension screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Assistant Editor(s)-in-Chief: Ralph Matar
Overview
Patients with a known BMPR2 mutation, scleroderma, and portal hypertension undergoing evaluation for liver transplantation should receive periodic screening for pulmonary hypertension (PH) through a thorough assessment of the presence of symptoms, physical examination, chest X ray, electrocardiography, and echocardiogram. Additional investigation with right heart catheterization should be performed if screening is suggestive of the presence of PH.
Screening
- Studies have not shown impact on outcomes with pulmonary hypertension screening;
- Despite that, it is expert consensus that some groups of patients must be screened for pulmonary hypertension such as:
- Patients with scleroderma spectrum disorders (especially the ones with corrected DLCO less than 80%);
- Patients with mutations for a heritable form of PAH;
- These patients must be screened annually with echocardiography.
Shown below is a table summarizing the recommended screening in several medical conditionas associated with elevated risk for PH.[1][2]
| Condition | Recommended screening |
| Known BMPR2 mutation | Echocardiogram (yearly) |
| BMPR2 mutation in a first degree relative | Genetic counseling BMPR2 genotyping |
| Family history for PAH in 2 or more relatives | Genetic counseling BMPR2 genotyping |
| Systemic sclerosis | Echocardiogram (yearly) |
| Portal hypertension | Echocardiogram if orthotopic liver transplantation is in consideration |
| Sickle cell disease | Echocardiogram (yearly) |
| Previous use of fenfluramine | Echocardiogram in case of symptoms |
| Congenital heart disease | Echocardiogram at the time of diagnosis |
Echocardiography findings that are suggestive of PH include:[3]
- Enlargement of the size of right atrium and right ventricle
- Decrease in the function of the right ventricle
- Displacement of the interventricular septum
- Tricuspid regurgitation
- Presence of pericardial effusion