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Diagnostic advances and opportunities in chronic thromboembolic pulmonary hypertension

, : Diagnostic advances and opportunities in chronic thromboembolic pulmonary hypertension. European Respiratory Review 24(136): 253-262

Chronic thromboembolic pulmonary hypertension (CTEPH) is characterised by the presence of thromboembolic material in the pulmonary circulation, and patients have a poor prognosis without treatment. Patients present with nonspecific symptoms, such as breathlessness and syncope, which means that other more common conditions are sometimes suspected before CTEPH, leading to delayed diagnosis and treatment. This is problematic because CTEPH is potentially curable with surgical pulmonary endarterectomy (PEA); indeed, CTEPH should always be considered in any patient with unexplained pulmonary hypertension (PH). Several key evaluations are necessary and complementary to confirm a diagnosis of CTEPH and assess operability. Echocardiography is initially used to confirm a general diagnosis of PH. Ventilation/perfusion scanning is then essential in the first stage of CTEPH diagnosis, with a wedge-shaped perfusion deficit indicative of CTEPH. This should be followed by right heart catheterisation (RHC) which is mandatory in confirming the diagnosis and providing haemodynamic parameters that are key predictors of the risk associated with PEA and subsequent prognosis. RHC is ideally coupled with conventional pulmonary angiography, the gold-standard technique for confirming the location and extent of disease, and thus whether the obstruction is surgically accessible. Computed tomographic pulmonary angiography is also now routinely used as a complementary technique to aid diagnosis and operability assessment. Recent improvements in the resolution of other noninvasive techniques, such as cardiac magnetic resonance imaging, allow for detailed reconstructions of the vascular tree and imaging of vessel defects, and interest in their use is increasing.


PMID: 26028637

DOI: 10.1183/16000617.00000915

Other references

Harradine, J., 1989: Topical issues in wildfowling. Unknown

Maar, D.; Litomerický, S., 1967: Significance of our experience in vocational rehabilitation of patients with osteoarticular tuberculosis. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca 34(2): 162-168

Pouliquen, A., 1983: The modernization of family farms in France and Poland: the extent of similarity. The short article compares the process of modernization of French family farming between 1945 and 1975 with the progress made in private farming in Poland between 1975 and 1980. It is argued that prior to 1945 and 1975 respectively, French and Pol...

Newsom H.E.; Noll P.D.J.; Maehr S.A.; Sims K.W.W., 1994: The depletion of W in the Earth's primitive mantle, a stumbling block for high temperature equilibrium core formation?. Abstracts of Papers Submitted to the Lunar and Planetary Science Conference 25, Part 2: 995-996

Vergani, P.; Locatelli, A.; Ghidini, A.; Strobelt, N.; Piccoli, M.G.; Ceruti, P.; Pezzullo, J.C., 1999: Optimal threshold of nuchal fold thickness to reduce the risk of down syndrome in women 35 years of age or older. American Journal of Obstetrics & Gynecology 180(1 PART 2): S163, Jan

Ozdalga, E.; Gratzinger, D., 2013: Histoplasmosis presenting with ulcers on the soft palate. Journal of General Internal Medicine 27(9): 1219-1219

Anonymous, 1978: International Labor Conference: Recommendation 157. Recommendations on employment and working and living conditions of nursing staff. Professioni Infermieristiche 31(2): 71-89

Beccaria E.; Ferrari A.; Nachtmann C.; Boniolo A.; Bovis M.; Zannino M.; Petruzzelli E., 1983: Rapid detection of antibodies to infectious bovine rhino tracheitis by macro and micro enzyme linked immuno sorbent assay. International Association Of Biological Standardization (Ed ) Developments in Biological Standardization, Vol 52 Herpesvirus Of Man And Animal: Standardization Of Immunological Procedures; Proceedings Of A Symposium; Lyon, France, Dec 7-9, 1981 X+571p S Karger: Basel, Switzerland; New York, N Y , Usa Illus P141-146, 1982

Klossowski, W.; Gronek, U.; Reszczyk, W.; Myszka, T., 1977: Growth and cropping of 4 plum cultivars under different soil management systems and fertilizer levels. Six different soil management systems and 4 NPK levels were tested in studies with the plum cvs Brzoskwiniowa, Oullins Golden, Italian Prune and Sweet Prune. In the 3 last named cvs trunk cross sectional area increment was greatest in trees grown...

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