Cardiac catheterization techniques in pulmonary hypertension
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Cardiac catheterization
Right heart catheterization
Pulmonary angiography
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Chronic thromboembolic pulmonary hypertension is clearly more common than previously was thought, and misdiagnosis is common because patients often present with nonspecific symptoms related to pulmonary hypertension. Computed tomography (CT) is a useful alternative to conventional angiography not only for diagnosing chronic pulmonary thromboembolism but also for determining which cases are treatable with surgery and confirming technical success postoperatively. Early recognition of chronic pulmonary thromboembolism may help improve the outcome, since the condition is potentially curable with pulmonary thromboendarterectomy.
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To the Editor:—
The authors share Dr. Smith's understandable curiosity concerning the nature of the patient's cardiac anomaly and would be most interested in the results of a second catheterization of the right side of the heart. However, we were mightily impressed with our patient's cardiorespiratory reserve, which far exceeded our own individually or as a relay team. There was no medical justification for repeating the studies, and try as we might, nowhere could we find that the number of research grants supporting a clinical investigation constituted an indication for cardiac catheterization.Right heart catheterization
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Unresolved thromboemboli in the pulmonary arteries (PAs) cause chronic thromboembolic pulmonary hypertension (CTEPH), which is usually diagnosed by mismatched perfusion defects on ventilation-perfusion lung scintigraphy and chronic thromboembolic signs on computed tomography (CT) scan and/or conventional pulmonary angiography. In our recent three cases of CTEPH (Case 1; …
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CATHETERIZATION of the left side of the heart1 2 3 4 has made possible a variety of physiologic investigations5 6 7 8 of the heart and circulation. In addition, measurements of pressures in the left side of the heart have been found invaluable in the precise characterization of lesions of the mitral and of the aortic valve. Such studies have also facilitated the clinical assessment of adult patients with acquired heart disease in whom the results of the usual clinical examinations and right-sided catheterization leave the diagnosis in doubt. In the present report the usefulness of catheterization of the left side of the heart is demonstrated . . .
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