title: Sickle-cell anemia and pulmonary hypertension.
abstract: OBJECTIVE
  To provide nurse practitioners (NPs) information about sickle-cell disease (SCD) and pulmonary hypertension (PHTN) as a complication. A case study is presented to illustrate the diagnosis of PHTN in a patient with SCD. Clinical manifestations, diagnosis, and interventions for both SCD and PHTN are also discussed.
  
  
  METHODS
  A literature search to support this case review was conducted in PubMed and SCOPUS using key search words. Specific information for the case study was obtained from a patient in a primary care setting.
  
  
  CONCLUSIONS
  Pulmonary hypertension is frequently diagnosed secondary to hemoglobinopathies such as SCD. Patients with sickle-cell anemia, a lifelong hereditary hemoglobinopathy, are now surviving into adulthood because of the advances made in treatment. About one third of these patients develop pulmonary hypertension, a complication that carries a 40% mortality rate. Delayed diagnosis can affect the patient's quality of life. Timely diagnosis and referral is imperative, but only if the advanced practitioner is able to recognize this common complication.
  
  
  CONCLUSIONS
  Many patients with SCD are seen in primary care practices. Such is the situation for the patient in this case study. Familiarity with pulmonary hypertension secondary to SCD can increase the awareness of NPs of this potential consequence and initiate early diagnostic evaluation.
authors.affiliation: Clark County Detention Center, Las Vegas, Nevada, USA.
authors.forename: Glenda M
authors.initials: GM
authors.lastname: Ninkovich
authors.forename: Sally K
authors.initials: SK
authors.lastname: Miller
authors.forename: Patricia T
authors.initials: PT
authors.lastname: Alpert
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D057179:Advanced Practice Nursing / Q000379:methods*; D000755:Anemia, Sickle Cell / Q000150:complications*; D000986:Antisickling Agents / Q000627:therapeutic use; D057210:Delayed Diagnosis; D006293:Health Promotion; D006801:Humans; D006976:Hypertension, Pulmonary / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D008297:Male; D009722:Nurse Practitioners / Q000458:organization & administration; D024802:Nurse's Role; D009730:Nursing Assessment; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000379:methods*; D012017:Referral and Consultation; D012307:Risk Factors; D012720:Severity of Illness Index; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000986:Antisickling Agents; D014665:Vasodilator Agents