Pulmonary hypertension screening: Difference between revisions
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**Patients with [[scleroderma]] spectrum disorders (especially the ones with corrected [[DLCO]] less than 80%); | **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]].<ref name="pmid33844574">{{cite journal| author=Poch D, Mandel J| title=Pulmonary Hypertension. | journal=Ann Intern Med | year= 2021 | volume= 174 | issue= 4 | pages= ITC49-ITC64 | pmid=33844574 | doi=10.7326/AITC202104200 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33844574 }} </ref> | ||
===Summary=== | |||
Shown below is a table summarizing the recommended screening in several medical conditionas associated with elevated risk for PH.<ref>ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension</ref><ref>ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension</ref> | Shown below is a table summarizing the recommended screening in several medical conditionas associated with elevated risk for PH.<ref>ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension</ref><ref>ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension</ref> | ||
Revision as of 18:46, 26 April 2021
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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
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.[1]
Summary
Shown below is a table summarizing the recommended screening in several medical conditionas associated with elevated risk for PH.[2][3]
| 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:[4]
- 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
References
- ↑ Poch D, Mandel J (2021). "Pulmonary Hypertension". Ann Intern Med. 174 (4): ITC49–ITC64. doi:10.7326/AITC202104200. PMID 33844574 Check
|pmid=value (help). - ↑ ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension
- ↑ ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension
- ↑ ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension