Diagnostics

GENERAL PRINCIPLES OF DIAGNOSIS

Diagnosing pulmonary hypertension requires collaborative efforts from both cardiologists and pulmonologists. A comprehensive diagnostic approach is essential and involves:

• ECG (Electrocardiogram)
• EchoCG (Echocardiogram)
• Chest X-ray
• Lung function and blood gas composition analysis
• Ventilation-perfusion lung scintigraphy
• CT (Computed Tomography)
• MRI (Magnetic Resonance Imaging)
• Pulmonary artery and right heart catheterization
• Angiopulmography
• Blood tests and immunological parameters
• Ultrasound of internal organs
• 6-Minute Walk Test
• Cardiopulmonary stress test

Functional classification of pulmonary hypertension is based on a modified version of the NYHA classification of heart failure (WHO, 1998):

• Class I: Patients with pulmonary hypertension experience no restrictions on physical activity. Ordinary physical activity does not induce shortness of breath, weakness, chest pain, or dizziness.
• Class II: Patients with pulmonary hypertension and reduced physical activity. They feel comfortable at rest, but ordinary physical activity causes shortness of breath, weakness, chest pain, and dizziness.
• Class III: Patients with pulmonary hypertension with severe limitations on physical activity. They feel comfortable at rest, but minimal physical activity induces shortness of breath, weakness, chest pain, and dizziness.
• Class IV: Patients with pulmonary hypertension who are unable to engage in physical activity without experiencing the above symptoms. Signs of right ventricular failure are evident. Shortness of breath and fatigue persist at rest, with discomfort escalating with minimal physical activity.

Key parameters indicating the severity of pulmonary hypertension and patients' life prognosis include signs of right ventricular failure, symptom progression rate, syncope occurrences, functional class (WHO), 6-Minute Walk Test distance, cardiopulmonary stress test results, BNP level in blood plasma, echocardiography parameters, and hemodynamic disorders.