Transthoracic echocardiography serves as the initial diagnostic tool for assessing pulmonary hypertension in children with congenital heart disease, requiring careful interpretation of complex anatomy.
How should transthoracic echocardiography be used for the assessment of pulmonary hypertension in children and adolescents with congenital heart disease?
This review highlights the critical role and specific considerations of using echocardiography to accurately diagnose and manage pulmonary hypertension in pediatric patients with congenital heart disease.
While invasive assessment of hemodynamics and testing of acute vasoreactivity in the catheterization laboratory is the gold standard for diagnosing pulmonary hypertension (PH) and pulmonary vascular disease (PVD) in children, transthoracic echocardiography (TTE) serves as the initial diagnostic tool. International guidelines suggest several key echocardiographic variables and indices for the screening studies when PH is suspected. However, due to the complex anatomy and special physiological considerations, these may not apply to patients with congenital heart disease (CHD). Misinterpretation of TTE variables can lead to delayed diagnosis and therapy, with fatal consequences, or-on the other hand-unnecessary invasive diagnostic procedures that have relevant risks, especially in the pediatric age group. We herein provide an overview of the echocardiographic workup of children and adolescents with PH with a special focus on children with CHD, such as ventricular/atrial septal defects, tetralogy of Fallot or univentricular physiology. In addition, we address the use of echocardiography as a tool to assess eligibility for exercise and sports, a major determinant of quality of life and outcome in patients with PH associated with CHD.
Meinel et al. (Thu,) conducted a review in Pulmonary hypertension and congenital heart disease. Transthoracic echocardiography was evaluated. Transthoracic echocardiography serves as the initial diagnostic tool for assessing pulmonary hypertension in children with congenital heart disease, requiring careful interpretation of complex anatomy.