Trow Terence K, McArdle John R
Section of Pulmonary and Critical Care Medicine, Division of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, P.O. Box 208057, New Haven, CT 06520-8057, USA.
Clin Chest Med. 2007 Mar;28(1):59-73, viii. doi: 10.1016/j.ccm.2006.11.001.
Accurate diagnosis of pulmonary arterial hypertension is a challenging and complex process that requires a high index of clinical suspicion from even the most astute clinician. This article discusses the use of a variety of noninvasive tests that can help define the population of patients in whom invasive cardiac catheterization should be pursued. It points out the vagaries and limitations of electrocardiography and the radiographic and echocardiographic clues to the diagnosis. Ultimately, right- and, often, concomitant left-heart catheterization is required to establish the diagnosis and distinguish pulmonary arterial hypertension from pulmonary venous hypertension.
准确诊断肺动脉高压是一个具有挑战性且复杂的过程，即使是最敏锐的临床医生也需要高度的临床怀疑指数。本文讨论了多种非侵入性检查的应用，这些检查有助于确定应进行有创心脏导管检查的患者群体。文中指出了心电图的多变性和局限性，以及诊断的影像学和超声心动图线索。最终，需要进行右心，且通常还需同时进行左心导管检查来确诊，并区分肺动脉高压和肺静脉高压。
