Chronic Thromboembolic Pulmonary Hypertension – Editorial
Belicová M. Chronic Thromboembolic Pulmonary Hypertension in a Regional Hospital. Vnitř Lék 2011; 57(2): 140–146.
The article by Assoc. Prof. Margita Belicová, MD, PhD., discusses the serious issue of chronic thromboembolic pulmonary hypertension. This diagnosis is not very common in doctors' offices, however, its determination is crucial for the patient's prognosis. It should be considered in patients with progressive exertional dyspnea. These patients are most often encountered by general practitioners, pulmonologists, internists, and cardiologists. Basic examinations should include, besides a careful medical history and physical findings, chest X-ray, EKG, and echocardiography. The EKG will show signs of right ventricular hypertrophy, while echocardiography will confirm pulmonary hypertension. Differential diagnosis is fairly broad and must exclude particularly severe pulmonary diseases leading to cor pulmonale, cardiac conditions (valvular defects, congenital defects), and primary pulmonary hypertension. Upon suspicion of thromboembolic pulmonary hypertension, CT pulmonary angiography and lung scintigraphy must be added. With significant suspicion, it is appropriate to refer the patient to a specialized center for diagnosing and treating thromboembolic pulmonary hypertension, where right heart catheterization and pulmonary angiography will be performed. Based on these findings, surgery – pulmonary thrombendarterectomy – is indicated. Correctly indicated surgical treatment significantly reduces pressure values in the right heart chambers and markedly improves the patient's prognosis.
asst. Prof. Ivan Řiháček, MD, PhD.
www.fnusa.cz
e-mail: rihacek@fnusa.cz
Submitted to the editorial office: August 18, 2010
Authors: I. Řiháček
Authors' Affiliation: 2nd Department of Internal Medicine, Faculty of Medicine MU and St. Anne's University Hospital Brno, Head: Prof. Miroslav Souček, MD, CSc.
Published in the journal: Vnitř Lék 2011; 57(2): 129
Category: Editorials
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