Types of pulmonary hypertension
1. Pulmonary Arterial Hypertension (PAH):
- Unknown (Idiopathic)
- Genetic
- Drug & Toxin exposure
- Diseases associated with PAH
- Connective Tissue (Scleroderma, Lupus, etc)
- HIV
- Portal Hypertension
- Congenital Heart Disease
2. Pulmonary Hypertension due to Left Heart Disease (PH-LHD):
- Coronary Artery Disease
- High Blood Pressure
- Damage to the Heart Muscle
- Heart Valve Disease
3. Pulmonary Hypertension due to Lung Diseases and/or Hypoxia (PH-Lung):
Pulmonary vessels are tightened in response to other lung disease, such as disease associated with PAH
- COPD
- Intersitital Lung Disease
- Any other lung disease causing low blood oxygen levels
4. Chronic Thromboembolic Pulmonary Hypertension (CTEPH):
PH caused by old, organized blood clots in the lungs that form a physical barrier to blood flow within the pulmonary arteries.
5. Pulmonary Hypertension with Unclear Multifactorial Mechanisms:
Associated Diseases:
- Sarcoidosis
- Blood disease (sickle cell anemia, chronic hemolytic anemia, etc.
- History of spleen removal
- Hematological
- Metabolic disease (Gaucher disease, thyroid disease)
Diagnosis of PH
Medical History and Symptoms Assessment:
Medical History and Symptoms Assessment:
Medical History and Symptoms Assessment:
Gathering your medical history and conducting a thorough assessment of your symptoms.
Inquiring about any breathing difficulties, fatigue, chest pain, or other symptoms you may be experiencing. Providing accurate and detailed information can help in the diagnostic process
Physical Examination:
Medical History and Symptoms Assessment:
Medical History and Symptoms Assessment:
A physical examination will be performed to assess your overall health, including listening to your heart and lungs, checking for signs of fluid retention or swelling, and examining your
Evaluation of Underlying Causes:
Medical History and Symptoms Assessment:
Multidisciplinary Team Evaluation:
Once PH is confirmed, further investigations may be necessary to identify the underlying causes. Additional tests may include autoimmune and rheumatologic screening, genetic testing, lung biopsy, or other specialised imaging studies.
Multidisciplinary Team Evaluation:
Multidisciplinary Team Evaluation:
Multidisciplinary Team Evaluation:
PH diagnosis and management often involve a multidisciplinary approach. A team of healthcare professionals, including pulmonologists, cardiologists, rheumatologists, and other specialists, collaborate to review your test results, discuss the best treatment options, and develop a personalised care plan.
Ongoing Monitoring:
Multidisciplinary Team Evaluation:
Ongoing Monitoring:
PH is a progressive condition, and regular monitoring is crucial. Follow-up appointments and routine tests, such as echocardiograms and blood tests, will be scheduled to assess your response to treatment, monitor disease progression, and make necessary adjustments to your care plan.
Diagnostic Tests:
Echocardiogram:
Pulmonary Function Tests (PFTs):
Pulmonary Function Tests (PFTs):
This non-invasive test uses sound waves to create images of the heart and assess its structure and function. It can help evaluate the size and function of the heart chambers, measure pulmonary artery pressures, and detect any abnormalities.
Pulmonary Function Tests (PFTs):
Pulmonary Function Tests (PFTs):
Pulmonary Function Tests (PFTs):
These tests measure lung function, including the volume of air you can inhale and exhale, the rate of airflow, and the efficiency of gas exchange. PFTs can help identify underlying lung conditions that may contribute to PH.
Blood Tests:
Pulmonary Function Tests (PFTs):
Cardiac Catheterization:
Blood samples are taken to evaluate oxygen levels, assess kidney and liver function, and measure specific biomarkers associated with PH. These tests can provide valuable information about the severity and potential causes of PH.
Cardiac Catheterization:
Ventilation/Perfusion (V/Q) Scan:
Cardiac Catheterization:
This invasive procedure involves inserting a thin, flexible tube (catheter) into a blood vessel and guiding it to the heart and pulmonary arteries. It measures pressures within the heart chambers and pulmonary arteries, assesses oxygen levels, and helps evaluate the response to vasodilator medications.
Ventilation/Perfusion (V/Q) Scan:
Ventilation/Perfusion (V/Q) Scan:
Ventilation/Perfusion (V/Q) Scan:
This test is used to assess blood flow and ventilation in the lungs. It can help detect blood clots or other obstructions in the pulmonary arteries that may contribute to PH.
CT Scan or MRI:
Ventilation/Perfusion (V/Q) Scan:
Ventilation/Perfusion (V/Q) Scan:
These imaging tests provide detailed images of the chest, allowing visualisation of the lungs, heart, and blood vessels. They can help identify structural abnormalities, evaluate lung diseases, and assess the overall condition of the heart and pulmonary arteries.