[Diagnosis of pulmonary hypertension: experiences with 187 patients referred to the VU Medical Center].
OBJECTIVE
To describe the results of a multidisciplinary diagnostic protocol in patients referred due to suspected pulmonary hypertension.


METHODS
Descriptive.


METHODS
In 187 patients who were referred to the VU Medical Centre, Amsterdam, the Netherlands, between May 1998 and February 2003, due to suspected pulmonary hypertension, the diagnosis was established by means of a multidisciplinary diagnostic protocol. The referral and final diagnoses were analysed, as well as the treatment the patients had received.


RESULTS
In 56 patients (30%), the application of the protocol lead to a modification of the diagnosis; 16 patients (9%) were found not to have pulmonary hypertension; in 20 of the 89 patients referred with 'primary pulmonary hypertension' (48% of all referrals), an underlying disease was still identified: 6 cases of a connective tissue disease, 5 cases of a chronic thromboembolic process, 5 cases of a condition of the left heart, and 4 cases of an atrial septal defect.


CONCLUSIONS
The diagnosis 'primary pulmonary hypertension' can only be made once all secondary types of the disease have been ruled out. The application of a multidisciplinary diagnostic protocol together with a contribution of specialists with specific expertise can help to adjust the initial diagnosis and sometimes even reject it.
Roeleveld
R J
RJ
Afd. Longziekten, VU Medisch Centrum, Postbus 7057, 1007 MB Amsterdam.
Boonstra
A B
AB
Voskuyl
A E
AE
Bronzwaer
J G
JG
Marques
K M
KM
vonk Noordegraaf
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003240:Connective Tissue Diseases / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000175:diagnosis; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D013923:Thromboembolism / Q000150:complications / Q000175:diagnosis; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis