Home - Link
Pulmonary Hypertension - Scottish Pulmonary Vascular Unit - Health Care Professional Section

 

WHAT IS PH?

REFERRAL GUIDELINES

TREATMENT

CLINICAL TRIALS

DISCLAIMER

........................................

HOME : NEWS

REFERRAL GUIDELINES : WHO TO SCREEN

WHO TO REFER / SUGGESTED ASSESSMENT PRIOR TO REFERRAL / HOW TO REFER / WHO TO SCREEN


Screening for pulmonary hypertension

 

Pulmonary hypertension should be considered (and assessed with echocardiogram) in the differential assessment of breathlessness in patients with:

 

  • Connective tissue disease (esp limited cutaneous sclerosis)
  • Past history of venous thromboembolism
  • Portal hypertension
  • HIV
  • Hypoxic lung disease (where there is unexplained deterioration or symptoms are excessive)
  • Sickle cell disease
  • Family history of pulmonary hypertension

 

Screening is currently recommended for patients at risk for chronic thromboembolic pulmonary hypertension & in patients with connective tissue disease

 

Screening for PH in connective tissue disease

 

Echocardiography & pulmonary function tests are recommended annually. Please refer for assessment if:

 

  • PA systolic pressure (PASP) is >40mmHg
  • PASP is 30-40mmHg and patient is symptomatic with no other explanation
  • Reduced gas transfer (Dlco <50% predicted) with no evidence of lung disease on HRCT
  • Strong clinical suspicion of pulmonary hypertension (symptoms & clinical signs) with inability to estimate PA pressure on echo

 

Screening for PH following PTE

 

Most patients who have had a submassive / massive PTE should be assessed at 6 months with an echocardiogram. Patients with recurrent events or evidence of persistent clot on imaging studies are at particular risk of developing pulmonary hypertension. Please refer for assessment if:

 

  • Convalescent PA systolic pressure (PASP) is >40mmHg
  • Persisting symptoms with evidence of persistent clot on V/Q scan &/or CTPA despite adequate anticoagulation

 

Border
SCOTTISH PULMONARY VASCULAR UNIT - All rights reserved - Clydebank, Scotland - 0141 951 5497 - SPVUnit@gjnh.scot.nhs.uk