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The Definite Haemodynamic Diagnosis Of Pulmonary Hypertension

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The definite haemodynamic diagnosis of pulmonary hypertension (PH) requires right heart catheterisation and direct measurements of right ventricular, pulmonary artery and pulmonary capillary wedge pressures and cardiac output. As this is an invasive test with risk and cost implications diagnostic algorithms have been devised that combines clinical assessment, non-imaging cardio-respiratory assessment and non-invasive imaging in patients suspected of having pulmonary hypertension. The initial aim is to establish a tentative diagnosis of pulmonary hypertension, to assess its severity and to identify the underlying aetiology. Subsequently non-invasive imaging techniques are used in monitoring disease progression as well as response to treatment in patients with pulmonary hypertension as an alternative to repeat invasive right heart catheterisation. In the future these imaging techniques may also help us to understand the cellular and molecular mechanisms responsible for the pathophysiology of pulmonary hypertension in both the pulmonary circulation and the right ventricle (RV).

Echocardiography

Morphological assessment of the Right heart and Pulmonary circulation

Two-dimensional echocardiography using a subcostal/ apical 4-chamber view have been used to obtain various variables (never ever use the word parameters) in the assessment of right ventricle morphology in patients with pulmonary hypertension. In two studies the right ventricular end diastolic dimension alone and
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