Pulmonary hypertension screening: Difference between revisions
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==Screening== | ==Screening== | ||
Patients who are considered at high risk for the development of | Patients who are considered at high risk for the development of pulmonary hypertension and require periodic screening include: | ||
*Those with a known BMPR2 mutation(Associated with Familial Pulmonary Hypertension). | *Those with a known BMPR2 [[mutation]](Associated with Familial Pulmonary Hypertension). | ||
*Those with Scleroderma spectrum of diseases. | *Those with [[Scleroderma]] spectrum of diseases. | ||
*Those with portal hypertension who are undergoing evaluation for liver transplantation. | *Those with [[portal hypertension]] who are undergoing evaluation for [[liver transplantation]]. | ||
The best study for screening patients suspected of having pulmonary hypertension based on history, physical examination, chest x-ray (CXR), and electrocardiogram (ECG) is an '''Echocardiogram'''. | The best study for screening patients suspected of having pulmonary hypertension based on history, [[physical examination]], [[chest x-ray]] (CXR), and [[electrocardiogram]] (ECG) is an '''[[Echocardiogram]]'''. | ||
These are the parameters that should be evaluated on Echocardiogram: | These are the parameters that should be evaluated on [[Echocardiogram]]: | ||
# | #Right atrial and right ventricular enlargement. | ||
#Reduced | #Reduced right ventricular function. | ||
#Displacement of the | #Displacement of the [[interventricular septum]]. | ||
#Tricuspid regurgitation(TR). | #[[Tricuspid regurgitation]](TR). | ||
#Tei index or myocardial performance index (measured by doppler Ultrasound). | #[[Tei index]] or [[myocardial]] performance index (measured by [[doppler Ultrasound]]). | ||
#Pericardial effusion (presence also indicates a higher mortality rate). | #[[Pericardial effusion]] (presence also indicates a higher mortality rate). | ||
The Tei index is an index of combined | The Tei index is an index of combined right ventricular [[systolic]] and [[diastolic]] function obtained by dividing the sum of both isovolumetric contraction and relaxation intervals by the ejection time. | ||
Evaluation for thromboembolic disease is also appropriate in all patients suspected of having Pulmonary Hypertension.<ref>ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension</ref> | Evaluation for thromboembolic disease is also appropriate in all patients suspected of having Pulmonary Hypertension.<ref>ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension</ref> | ||
Revision as of 19:16, 22 September 2011
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Pulmonary Hypertension Microchapters |
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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,
Screening
Patients who are considered at high risk for the development of pulmonary hypertension and require periodic screening include:
- Those with a known BMPR2 mutation(Associated with Familial Pulmonary Hypertension).
- Those with Scleroderma spectrum of diseases.
- Those with portal hypertension who are undergoing evaluation for liver transplantation.
The best study for screening patients suspected of having pulmonary hypertension based on history, physical examination, chest x-ray (CXR), and electrocardiogram (ECG) is an Echocardiogram.
These are the parameters that should be evaluated on Echocardiogram:
- Right atrial and right ventricular enlargement.
- Reduced right ventricular function.
- Displacement of the interventricular septum.
- Tricuspid regurgitation(TR).
- Tei index or myocardial performance index (measured by doppler Ultrasound).
- Pericardial effusion (presence also indicates a higher mortality rate).
The Tei index is an index of combined right ventricular systolic and diastolic function obtained by dividing the sum of both isovolumetric contraction and relaxation intervals by the ejection time.
Evaluation for thromboembolic disease is also appropriate in all patients suspected of having Pulmonary Hypertension.[1]
References
- ↑ ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension