Pulmonary hypertension screening: Difference between revisions
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Patients who are considered at high risk for the development of pulmonary hypertension and require periodic screening include: | Patients who are considered at high risk for the development of pulmonary hypertension and require periodic screening include: | ||
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|''' | | style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 40%" align=center |'''Condition''' | style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 60%" align=center |'''Recommended screening''' | ||
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|'''BMPR2 [[mutation]] | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |''' Known [[BMPR2]] [[mutation]]''' || style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |[[Echocardiogram]] (yearly) | ||
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|''' | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''BMPR2 [[mutation]] in a first degree relative''' || style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |[[Genetic counseling]] <br> [[BMPR2]] genotyping | ||
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|''' | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Family history for PAH in 2 or more relatives'''||style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | [[Genetic counseling]] <br> [[BMPR2]] genotyping | ||
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|'''[[ | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[Systemic sclerosis]]'''|| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |[[Echocardiogram]] (yearly) | ||
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|'''[[ | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[Portal hypertension]]''' || style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |[[Echocardiogram]] if orthotopic liver transplantation is in consideration | ||
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|''' | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[Sickle cell disease]]''' || style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |[[Echocardiogram]] (yearly) | ||
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|'''[[Congenital heart disease]]''' || [[Echocardiogram]] at the time of diagnosis | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Previous use of [[fenfluramine]]''' || style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |[[Echocardiogram]] in case of symptoms | ||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[Congenital heart disease]]''' || style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |[[Echocardiogram]] at the time of diagnosis | |||
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Revision as of 21:12, 28 August 2014
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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.[1]
Screening
Patients who are considered at high risk for the development of pulmonary hypertension and require periodic screening include:
| Condition | style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 60%" align=center |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 |
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.
References
- ↑ ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension