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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2008 December;47(4):165-74
Diagnostic evaluation for pulmonary arterial hypertension
Modrykamien A. M., Minai O. A.
Department of Pulmonary, Allergy and Critical Care Respiratory Institute, Cleveland Clinic Cleveland, OH, USA
Pulmonary arterial hypertension (PAH) is a chronic disorder of the pulmonary circulation defined by a mean pulmonary artery pressure (mPAP) >25 mmHg at rest or >30 mmHg during exercise, without concomitant elevation in pulmonary venous pressure. Its early detection, with early institution of therapy, is thought to possibly impact reversibility and therefore improve survival. A high clinical index of suspicion should be maintained in patients with symptoms in the presence of predisposing conditions. Optimal care of patients with suspected PAH requires a multidisciplinary approach with collaboration between community resources and physicians with expertise in pulmonary, cardiac, and rheumatologic disorders. This review will discuss the clinical manifestations of patients with suspected PAH and the use of imaging, pulmonary function tests, serologic tests, biomarkers, and right heart catheterization to arrive at the correct diagnosis.