[Screening and diagnosis of pulmonary arterial hypertension. Comments regarding the latest guidelines from the European Societies of Cardiology and of Pulmonology].
Transthoracic echocardiogram is the best tool for the screening of PH. When PH is suspected, the diagnosis must be confirmed by a right heart catheterization, and a vasoreactivity testing with NO must be performed in all cases of pulmonary arterial hypertension. Next steps for the work-up include: defining the type of PH (precapillary or postcapillary) and etiology, assessing prognostic factors, initiating therapy (if required) and following up the patient (particularly response to therapy). Routine screening is warranted in systemic sclerosis, HIV infection and portal hypertension. All patients with PH must be referred to a reference or a competence center for PH.
de Groote
Pascal
P
CHRU, Hôpital Cardiologique, Service de Cardiologie C, Pôle de Cardiologie et Maladies Vasculaires, 59037 Lille cedex, Centre de Compétences HTAP. Université de Lille 2, France.
Lamblin
Nicolas
N
Launay
David
D
Bervar
Jean-François
JF
Hachulla
Eric
E
D000465:Algorithms; D001993:Bronchodilator Agents; D006328:Cardiac Catheterization; D002309:Cardiology / Q000379:methods / Q000592:standards; D015984:Causality; D003663:Decision Trees; D017548:Echocardiography, Transesophageal; D055317:Evidence-Based Practice; D015658:HIV Infections / Q000150:complications; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D006976:Hypertension, Pulmonary / Q000145:classification / Q000175:diagnosis* / Q000209:etiology*; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D009569:Nitric Oxide; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D015272:Pulmonary Medicine / Q000379:methods / Q000592:standards; D012017:Referral and Consultation; D012595:Scleroderma, Systemic / Q000150:complications; D012720:Severity of Illness Index
D001993:Bronchodilator Agents; D009569:Nitric Oxide