A simplified case-based diagnostic approach to elevated pulmonary pressures on echocardiography aims to facilitate early recognition and referral of high-risk patients with pulmonary hypertension.
This review provides a simplified, case-based approach to the diagnostic work-up of pulmonary hypertension following the finding of elevated pulmonary pressures on echocardiography to prevent delayed diagnosis and treatment.
An elevated right ventricular/pulmonary artery systolic pressure suggestive of pulmonary hypertension (PH) is a common finding noted on echocardiography and is considered a marker for poor clinical outcomes, regardless of the cause. Even mild elevation of pulmonary pressure can be considered a modifiable risk factor, informing the trajectory of patients' clinical outcome. Although guidelines have been published detailing diagnostic and management algorithms, this echocardiographic finding is often underappreciated or not acted upon. Hence, patients with PH are often diagnosed in clinical practice when hemodynamic abnormalities are already moderate or severe. This results in delayed initiation of potentially effective therapies, referral to PH centers, and greater patient morbidity and mortality. This mini-review presents a succinct, simplified case-based approach to the "next steps" in the work-up of PH, once elevated pulmonary pressures have been noted on an echocardiogram. Our goal is for clinicians to develop a good overview of diagnostic approach to PH and recognition of high-risk features that may require early referral.
Kanwar et al. (Mon,) conducted a review in Pulmonary hypertension. Diagnostic approach to elevated pulmonary pressure was evaluated. A simplified case-based diagnostic approach to elevated pulmonary pressures on echocardiography aims to facilitate early recognition and referral of high-risk patients with pulmonary hypertension.