A diagnostic algorithm for pulmonary hypertension due to left heart disease in resource-limited settings: can busy clinicians adopt a simple, practical approach?

Cardiovasc J Afr

Hatter Institute for Cardiovascular Research in Africa, South African Medical Research Council Cape Heart Centre, IDM, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Published: June 2019


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Article Abstract

Pulmonary hypertension (PH) has progressively moved from an orphan disease to a significant global health problem with a major disease burden in limited7hyphen;resource countries, where over 97% of patients live. The aetiologies of PH differ between high- and low-income nations, but PH due to left heart disease is credited to be the most frequent contemporary form. Although a straightforward diagnosis of PH requires the use of right heart catheterisation (RHC), access to equipment for RHC is a deterrent. Furthermore, the risk associated with RHC limits its uptake to a selection of specialised centres. Moreover, the rigour and clinical reasoning for diagnosis in clinical medicine is rapidly changing and revealing that PH can complicate a diverse range of medical conditions needing other explorations. In this article, we provide for the busy clinician, a simplified diagnostic algorithm for PH that is relevant for making a correct early diagnosis and limiting the impact of PH.

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http://dx.doi.org/10.5830/CVJA-2018-042DOI Listing

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