Pulmonary Vascular Disease
Tests for Pulmonary Vascular Disease continued...
Echocardiography (echocardiogram): An ultrasound video of the beating heart. Congestive heart failure, heart valve disease, and other conditions contributing to pulmonary vascular disease can be discovered with echocardiogram.
Right heart catheterization: A pressure sensor is inserted through a needle into a vein in the neck or groin. A doctor advances the sensor through the veins, into the right heart, then into the pulmonary artery. Right heart catheterization is the best test to diagnose pulmonary arterial hypertension.
Chest X-ray film: A simple chest X-ray can't diagnose pulmonary vascular disease. However, it may identify contributing lung disease, or show enlarged pulmonary arteries that suggest pulmonary arterial hypertension.
Pulmonary angiography (angiogram): Contrast dye is injected into the blood, and X-ray images of the chest show detailed images of the pulmonary arterial system. Angiography is very good at diagnosing pulmonary embolism but is rarely performed anymore because CT scans are easier, less invasive, and have lower risk.
Treatments for Pulmonary Vascular Disease
There are many different treatments for pulmonary vascular disease. Pulmonary vascular disease is treated according to its cause.
Pulmonary embolism: Blood clots to the lungs are treated with blood thinners (anticoagulation). The most often used medicines are heparin, enoxaparin (Lovenox) and warfarin (Coumadin).
Chronic thromboembolic disease: Serious cases of thromboembolic disease may be treated with surgery to clear out the pulmonary arteries (thromboendarterectomy). Blood thinners are also used. Riociguat (Adempas) is a drug approved for use after surgery or in those who can't have surgery, to improve the ability to exercise.
Pulmonary arterial hypertension: Several medicines can lower blood pressure in the pulmonary arteries:
These drugs have been best shown to improve idiopathic pulmonary arterial hypertension.
Pulmonary venous hypertension: Because this form of pulmonary vascular disease is usually caused by congestive heart failure, these treatments for heart failure are usually appropriate: