Pulmonary hypertension: the importance of correctly diagnosing the cause

Abstract

Pulmonary hypertension (PH) is a complex condition that can occur as a result of a wide range of disorders, including left heart disease, lung disease and chronic pulmonary thromboembolism. Contemporary PH patients are older and frequently have a multitude of comorbidities that may contribute to or simply coincide with their PH. Identifying the cause of PH in these complicated patients can be challenging but is essential, given that the aetiology of the disease has a significant impact on the management options available. In this article, we present two cases that highlight the difficulties involved in obtaining a precise diagnosis of the cause of PH within the setting of multiple comorbidities. The importance of performing a comprehensive, multidimensional diagnostic work-up is demonstrated, in addition to the need to specifically consider cardiopulmonary haemodynamic data in the context of the wider clinical picture. The article also illustrates why achieving an accurate diagnosis is necessary for optimal patient management. This may involve treatment of comorbidities as a priority, which can ameliorate the severity of PH, obviating the need to consider PH-targeted medical treatment.

Adding value to myocardial perfusion SPECT/CT studies that include coronary calcium CT

“…Similarly studies have shown that PAH is a common complication of left heart dysfunction, which is often encountered in patients with advanced age, essential hypertension, atrial fibrillation, diabetes mellitus, etc. [ 16 , 17 ] In keeping with these findings, our study showed that there was a significant correlation between BMI and mPAD. Our findings also demonstrate that there was a higher incidence of hypertension and CHF in patients with mPAD > 29.5 mm.…”

The revolution of pulmonary arterial hypertension

“…Two further papers address special conditions such as the management of adult patients after the Fontan procedure [10] and the risks and difficulties of managing PAH in pregnant women [11]. This series of cutting-edge papers begins with an article by MEHTA and VACHIÉRY [12] emphasising the importance of making the right diagnosis of pulmonary hypertension, and discussing illustrative cases of great educational value (figure 2). Together, these contributions offer an excellent up-to-date focus on pulmonary hypertension topics observed from a variety of view-points from world-renowned experts in the field.…”