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Dtsch Med Wochenschr. 2008 Oct;133 Suppl 6:S173-5. doi: 10.1055/s-0028-1091231. Epub 2008 Sep 23.

[Echocardiography and magnetic resonance imaging in patients suffering from pulmonary arterial hypertension].

[Article in German]

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Lungenhochdruckambulanz, Thoraxklinik Heidelberg.


The therapeutic options for pulmonary arterial hypertension (PAH) have significantly improved in the last few years. But the disease is still too often diagnosed late in its course. In more than 80% of patients the diagnosis is made and treatment started when the condition is already in NYHA class III-IV with a very poor prognosis. According to the EARLY study, beginning treatment 3 - 6 months earlier can improve prognosis and progression of the PHT. Late diagnosis is first of all due to the fact that it is asymptomatic in the early stages, such symptoms as dyspnoea, peripheral edema or syncope frequently occurring only when there are already signs of heart failure. Secondly, there is as yet no method for the early diagnosis of PHT. But echocardiography and magnetic resonance imaging (MRI) are non-invasive modes that are important for screening and follow-up. Among noninvasive methods echocardiography shows the greatest diagnostic sensitivity and specificity. It should be undertaken in all patients in whom pulmonary hypertension (PHT) is suspected. But because of the particular geometry of the right ventricle its examination is difficult. New diagnostic techniques allow for assessment of additional information of right ventricular function. Right heart catheterization is essential for further elucidating PHT.

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