Type:
Educational Exhibit
Keywords:
Embolism / Thrombosis, Education and training, Education, Diagnostic procedure, MR, CT-Angiography, CT, Pulmonary vessels, Lung, Cardiovascular system
Authors:
J. Carvalho1, J. Amorim1, A. M. Alves1, J. S. F. Pinto2, C. Fernandes1, M. França3; 1Porto/PT, 2Porto, PT/PT, 3Maia/PT
DOI:
10.26044/ecr2019/C-2279
Background
PH is defined as an increase in mean pulmonary arterial pressure ≥25mmHg at rest assessed by right heart catheterization (RHC).
The latest World Health Organization,
revised in Nice,
France,
in 2013,
divides PH in five different groups,
according to their clinical presentation,
pathologic findings and treatment strategies:
Group 1: Pulmonary artery hypertension (PAH)
Group 2: PH due do left heart disease
Group 3: PH due to lung diseases and/or hypoxia
Group 4: Chronic thromboembolic PH (CTEPH)
Group 5: PH with unclear and/or multifactorial mechanisms.
The diagnostic algorithm suggested by the 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension is summarized in Fig. 1.
After clinical suspicion and compatible echocardiography,
which is recommended as the first-line non-invasive diagnostic investigation,
further investigation is usually necessary to appropriately characterize the disease.
Apart from imaging methods,
other available tests might provide the clinician with a specific etiology and prognostic information.