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Echocardiography in pediatric pulmonary hypertension.

Jone PN, Ivy DD - Front Pediatr (2014)

Bottom Line: Pulmonary hypertension (PH) can be a rapidly progressive and fatal disease.Although right heart catheterization remains the gold standard in evaluation of PH, echocardiography remains an important tool in screening, diagnosing, evaluating, and following these patients.In this article, we will review the important echocardiographic parameters of the right heart in evaluating its anatomy, hemodynamic assessment, systolic, and diastolic function in children with PH.

View Article: PubMed Central - PubMed

Affiliation: Pediatric Cardiology, Children's Hospital Colorado, University of Colorado School of Medicine , Aurora, CO , USA.

ABSTRACT
Pulmonary hypertension (PH) can be a rapidly progressive and fatal disease. Although right heart catheterization remains the gold standard in evaluation of PH, echocardiography remains an important tool in screening, diagnosing, evaluating, and following these patients. In this article, we will review the important echocardiographic parameters of the right heart in evaluating its anatomy, hemodynamic assessment, systolic, and diastolic function in children with PH.

No MeSH data available.


Related in: MedlinePlus

Spectral Doppler pattern across a ventricular septal defect with low velocity left to right shunt (A) indicating pulmonary hypertension and high velocity left to right shunt (B) indicating low pulmonary pressure. Spectral Doppler pattern across patent ductus arteriosus with continuous high velocity left to right shunt (C) indicating lower pulmonary artery pressure compared to aortic pressure and bidirectional shunt (D), indicating pulmonary hypertension.
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Figure 6: Spectral Doppler pattern across a ventricular septal defect with low velocity left to right shunt (A) indicating pulmonary hypertension and high velocity left to right shunt (B) indicating low pulmonary pressure. Spectral Doppler pattern across patent ductus arteriosus with continuous high velocity left to right shunt (C) indicating lower pulmonary artery pressure compared to aortic pressure and bidirectional shunt (D), indicating pulmonary hypertension.

Mentions: Estimation of SPAP can also be made in the presence of ventricular septal defect (VSD). This can only be done if there is no RV or LV outflow tract obstruction. This method has been shown to correlate well with invasive measurements obtained by cardiac catheterization (32, 33). The equation is below:SPAP=Systolic blood pressure (SBP)−4V (VSD) max⁡2     (for left to right shunts)SPAP=SBP+4V (VSD) max⁡2 (for right to left shunts)The maximal velocity across the ventricular septal defect is V(VSD)max. Flow direction and velocity across the VSD may help in the diagnosis of PH. Right to left shunt across the VSD and low velocity left to right shunt may suggest the presence of elevated pulmonary pressure (Figure 6). Parasternal and subcostal long axis views are used to interrogate perimembranous VSDs whereas parasternal and subcostal short axis views are best used to interrogate muscular VSDs.


Echocardiography in pediatric pulmonary hypertension.

Jone PN, Ivy DD - Front Pediatr (2014)

Spectral Doppler pattern across a ventricular septal defect with low velocity left to right shunt (A) indicating pulmonary hypertension and high velocity left to right shunt (B) indicating low pulmonary pressure. Spectral Doppler pattern across patent ductus arteriosus with continuous high velocity left to right shunt (C) indicating lower pulmonary artery pressure compared to aortic pressure and bidirectional shunt (D), indicating pulmonary hypertension.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4228850&req=5

Figure 6: Spectral Doppler pattern across a ventricular septal defect with low velocity left to right shunt (A) indicating pulmonary hypertension and high velocity left to right shunt (B) indicating low pulmonary pressure. Spectral Doppler pattern across patent ductus arteriosus with continuous high velocity left to right shunt (C) indicating lower pulmonary artery pressure compared to aortic pressure and bidirectional shunt (D), indicating pulmonary hypertension.
Mentions: Estimation of SPAP can also be made in the presence of ventricular septal defect (VSD). This can only be done if there is no RV or LV outflow tract obstruction. This method has been shown to correlate well with invasive measurements obtained by cardiac catheterization (32, 33). The equation is below:SPAP=Systolic blood pressure (SBP)−4V (VSD) max⁡2     (for left to right shunts)SPAP=SBP+4V (VSD) max⁡2 (for right to left shunts)The maximal velocity across the ventricular septal defect is V(VSD)max. Flow direction and velocity across the VSD may help in the diagnosis of PH. Right to left shunt across the VSD and low velocity left to right shunt may suggest the presence of elevated pulmonary pressure (Figure 6). Parasternal and subcostal long axis views are used to interrogate perimembranous VSDs whereas parasternal and subcostal short axis views are best used to interrogate muscular VSDs.

Bottom Line: Pulmonary hypertension (PH) can be a rapidly progressive and fatal disease.Although right heart catheterization remains the gold standard in evaluation of PH, echocardiography remains an important tool in screening, diagnosing, evaluating, and following these patients.In this article, we will review the important echocardiographic parameters of the right heart in evaluating its anatomy, hemodynamic assessment, systolic, and diastolic function in children with PH.

View Article: PubMed Central - PubMed

Affiliation: Pediatric Cardiology, Children's Hospital Colorado, University of Colorado School of Medicine , Aurora, CO , USA.

ABSTRACT
Pulmonary hypertension (PH) can be a rapidly progressive and fatal disease. Although right heart catheterization remains the gold standard in evaluation of PH, echocardiography remains an important tool in screening, diagnosing, evaluating, and following these patients. In this article, we will review the important echocardiographic parameters of the right heart in evaluating its anatomy, hemodynamic assessment, systolic, and diastolic function in children with PH.

No MeSH data available.


Related in: MedlinePlus