Diagnostic features of pulmonary hypertension in primary health care

   Aim. To identify the clinical, diagnostic, structural, functional, and hemodynamic parameters of the heart in patients with idiopathic pulmonary arterial hypertension (IPAH) and pulmonary hypertension (PH) associated with heart failure (HF) of ischemic origin to improve early diagnosis and differentiation of PH in primary health care, as well as to evaluate the practical applicability of a questionnaire as a primary screening tool for PH.

   Material and methods. A total of 63 patients were examined. There were 32 patients with IPAH and 31 with HF-related PH. Following standard diagnostic methods were used: electrocardiography, echocardiography, chest X-ray, Holter monitoring, and laboratory tests. A specialized screening questionnaire developed by specialists at the Chazov National Medical Research Center of Cardiology was used for the early detection of PH. Final diagnosis was confirmed by transvenous right heart catheterization.

   Results. Patients with IPAH were younger and predominantly female. This group of patients demonstrated more pronounced PH, hypertrophy and dilation of the right ventricles with preserved left ventricular function. In the group of PH with HF of ischemic origin, significant left heart structural changes were observed, including increased left ventricular size and volume, decreased ejection fraction, and increased pulmonary wedge pressure.

   Conclusion. The study demonstrated significant clinical, anamnestic, and hemodynamic differences between various forms of PH, as well as the effectiveness of a screening questionnaire for the early detection of PH. This allows for optimized routing and improved prognosis for patients in primary care.

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