Pulmonary hypertension (PH) is a disease characterized by high blood pressure in the lungs due to narrowed pulmonary arteries. These vessels are responsible for transporting blood from the heart to the lungs, and as they become blocked, the heart needs to work harder to properly pump the blood. The extra effort may result in symptoms like shortness of breath (dyspnea), fatigue, dizziness or fainting, chest pressure or pain, edema, and irregular heart beat, as well as enlargement and weakening of the heart and eventually in right heart failure.
There is currently no cure for pulmonary hypertension, but there are treatments that can help ease the symptoms and improve patients’ quality of life. However, the diagnosis is not easy, which can delay the administration of a proper treatment. The disease is not detected in routine physical exams, and the symptoms may be confused with other heart or lung condition. To confirm the diagnostic, physicians usually request numerous tests, being one of the most common the echocardiogram exam.
Pulmonary Hypertension and Echocardiogram: Diagnosis
An echocardiogram exam is not the most accurate test for diagnosing pulmonary hypertension, but it is usually one of the first tests requested when there are suspicions of the disease. With the results of an echocardiogram, physicians are able to examine the right side chambers of the heart, as well as heart valves. By doing so, physicians can evaluate heart enlargement, thickening of the heart walls, the aspect of the septum, and the potential existence of abnormal fluid around the heart.
The image of the heart valves can help detect a congenital heart disease, while physicians can also use an equation to calculate the estimated pulmonary artery pressure. In addition, other findings may help diagnose PH, including enlarged right atrium, enlarged right ventricle with thick wall, and septal shift into the left side of the heart caused by enlarged right ventricles. When any of these signs of pulmonary hypertension are identified in an echocardiogram, more exams are requested to confirm the diagnosis.
Different Types of Echocardiogram Procedures
The echocardiogram is a simple procedure, and includes an ultrasound of the heart conducted by an ultrasound technician to be examined by a cardiologist. The patient is usually lying down in a dark room and a transducer attached to a computer is used on the patient’s chest. The procedure is also used in pregnant women, and similarly a clear jelly is used to improve the transducer’s accuracy. The equipment will emit sounds and as it echoes in the patient’s bones and organs, and a moving image can be seen on the screen.
A doppler echocardiogram is the most common noninvasive echo required, which is conducted at rest as described. However, the physician may also ask for an exercise echocardiogram, which helps determine the heart’s function under stress. This exam is conducted on a stationary bike or treadmill. In addition, a transesophageal echocardiogram is prescribed when there isn’t a clear image of the heart and lungs. During this procedure, a flexible tube with a transducer is placed down the throat and into the esophagus to provide detailed images of the heart. Following the confirmation of the diagnosis, the exam may be repeated to evaluate the severity of the disease.
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