A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) due topossible: Neck vein congestion? Signs of increased right ventricular filling pressure include jugular venous congestion (JVD) or increased jugular venous pressure (JVP). Elevated JVD is commonly seen in … Pulmonary Hypertension: Examination
1st-order laboratory parameters-obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Fasting glucose (fasting blood sugar) Blood gas analysis (BGA) High-sensitivity cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – for suspected myocardial infarction (heart attack). D-dimer – for suspected thrombosis or pulmonary embolism. NT-proBNP (N-terminal pro brain natriuretic peptide) – if … Pulmonary Hypertension: Test and Diagnosis
Therapeutic Targets To turn patients into low-risk patients through therapy, i.e., improve prognosis Curative therapy for pulmonary therapy does not exist. Therapy recommendations Treatment of the underlying disease Reduction of pressure in the pulmonary circulation: Initial therapy or main therapy depending on the degree of heart failure (NYHA): endothelin receptor antagonists (ERA), PDE-5 inhibitors, prostacyclin … Pulmonary Hypertension: Drug Therapy
Mandatory medical device diagnostics. Echocardiography (echo; cardiac ultrasound) – to measure tricuspid regurgitation (leakage leading to backflow of blood from the right ventricle into the right atrium) and so-called TAPSE (abbreviation for: “tricuspid annular plane systolic excursion”); this allows indirect estimation of systolic pulmonary arterial pressure; measurement of TAPSE is performed using M-mode and describes … Pulmonary Hypertension: Diagnostic Tests
The following measures may be available if there is an inadequate response. Balloon atrioseptostomy (rupture of the atrial septum by balloon catheter) to relieve right ventricular pressure by right-to-left shunt Lung Transplantation (LUTX). Further notes Chronic thromboembolic pulmonary hypertension (CTEPH) – Symptoms: Exertional dyspnea, chest pain, fatigue, edema, or syncope (brief loss of consciousness); Diagnosis: … Pulmonary Hypertension: Surgical Therapy
The following symptoms and complaints may indicate pulmonary hypertension (pulmonary hypertension): Exertional dyspnea (shortness of breath on exertion), even at low levels of exertion (98% of patients), depending on the severity of symptoms of the disease. Dyspnea during bending (= bendopnea; to bend, i.e., bend, stoop). Weakness/chronic fatigue/fatigue/fatigue (73%). Chest pain (chest pain; 47%). Fast … Pulmonary Hypertension: Symptoms, Complaints, Signs
Pathogenesis (development of disease) The cause of primary pulmonary hypertension (PH; pulmonary hypertension) is unknown. PH in left heart disease (group 2) represents the most common form of PH, accounting for up to 50% of all cases. PH due to pulmonary disease and/or hypoxia (group 3) represents the second largest PH group numerically (approximately 30-45%). … Pulmonary Hypertension: Causes
General measures Presentation of the patient to a specialized PH center in cases of suspected PAH and evidence of severe PH associated with left heart or lung disease, among others. Pregnancy should be avoided. Travel recommendations: No travel at altitudes > 2,000 m No hot or humid climate Short flights; long flights can lead to … Pulmonary Hypertension: Therapy
Medical history (history of illness) is an important component in the diagnosis of pulmonary hypertension (pulmonary hypertension). Family history Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to harmful working substances in your profession? Current medical … Pulmonary Hypertension: Medical History
Respiratory System (J00-J99) Bronchial asthma Chronic obstructive pulmonary disease (COPD) Interstitial lung disease Pulmonary emphysema – condition in which there is increased air in the lungs. However, the gas exchange area is decreased. The reason for this is a destruction of the parenchyma (lung tissue). Pulmonary fibrosis – connective tissue remodeling of the lungs, which … Pulmonary Hypertension: Or something else? Differential Diagnosis
