Monday, March 12, 2007
Pulmonary HTN question
case comments: This is just a question: Are most of you still routinely performing a right heart catheterization prior to treatment initiation in patients with pulmonary hypertension - even in those associated with collagen vascular disease, etc? What do you use as your drug of choice for vasodilatory testing? Do you routinely perform a left heart cath as well?
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We have been performing a R heart cath prior to Tx because the ECHO so often misses the mark on the pressures. We don't have a standard protocol but because of the hardships with pumps we have mostly been using Bosentan or Sildenafil.
Any thoughts on when or whether to perform a right heart cath on elderly patients (say, 75-80+ years) referred for elevated PA pressures found on TTE?
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