Detect

After recognising symptoms suggestive of PAH, several key investigations can be used to assess if a PAH diagnosis is likely.1 Interpretation of these results is complex and requires substantial experience in the management of PAH.1 It is therefore recommended in the diagnostic algorithm that suspected PAH patients be referred to a PAH expert centre.1 These centres have the expertise to definitively diagnose PAH through right heart catheterisation, and then provide a treatment and management plan for patients.1

In Australia, the average delay from symptom onset to diagnosis of PAH is almost 4 years.2 It is critically important for physicians to expedite this process and help prevent these delays. If you suspect PAH, you should promptly investigate further to identify signs of PAH.1

NEXT STEPS

If your investigations indicate PAH, then you should immediately refer your patient to a PAH expert centre to confirm the diagnosis.1

If you’re unsure whether to refer, click here.

References
  1. Galiè N, et al. Eur Heart J 2016; 37:67–119.
  2. Strange G, et al. Pulm Circ 2013; 3:89–94.
Footnotes
PAH=pulmonary arterial hypertension; PH=pulmonary hypertension.

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This content is intended for Australian healthcare professionals. For more information on pulmonary hypertension, please contact your healthcare professional.
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World Health Organization functional class (WHO-FC) for patients with PH3,5

This system grades PH severity according to the patient’s functional status, by linking symptoms with activity limitations. WHO-FC remains a powerful predictor of outcomes in patients with PAH.

WHO - FC Description
I
Patients with PH in whom there is no limitation of usual physical activity; ordinary physical activity does not cause increased dyspnoea, fatigue, chest pain, or presyncope.
II
Patients with PH who have mild limitation of physical activity. There is no discomfort at rest, but normal physical activity causes increased dyspnoea, fatigue, chest pain, or presyncope.
III
Patients with PH who have a marked limitation of physical activity. There is no discomfort at rest, but less than ordinary activity causes increased dyspnoea, fatigue, chest pain, or presyncope.
IV
Patients with PH who are unable to perform any physical activity at rest and who may have signs of right ventricular failure. Dyspnoea and/or fatigue may be present at rest, and symptoms are increased by almost any physical activity.
Adapted from McGoon M, et al. 2004.5
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This website is intended for Australian healthcare professionals only