Echocardiography in the differential diagnosis of the causes of pulmonary hypertension on the example of clinical cases

The importance of timely diagnosis of pulmonary hypertension in primary health care is difficult to overestimate, since this condition is characterized by a low five-year survival rate, is characterized by difficulty in establishing a diagnosis, low alertness and insufficient awareness of clinicians about this disease. The article presents the main methods of diagnosis of pulmonary hypertension, provides data typical for three hemodynamic types of pulmonary hypertension. Echocardiographic diagnosis of pulmonary hypertension is the most widely used instrumental method, since the method is accessible to a primary care physician and allows identifying patients who need to be referred for further examination using invasive technologies. The role and significance of measuring the rate of tricuspid regurgitation of 2.8 m/s in the diagnosis of this pathological condition is indicated. The advantages and place of transthoracic echocardiography in the noninvasive diagnosis of the hemodynamic variant of pulmonary hypertension are shown by determining the maximum rate of early diastolic filling of the left ventricle (E) and the maximum rate of early diastolic displacement of the lateral segment of the mitral valve ring (e') according to the Nagueh formula. The article presents clinical cases demonstrating the capabilities of transthoracic echocardiography in detecting pulmonary hypertension and determining its hemodynamic type. The determination of the hemodynamic type of pulmonary hypertension by noninvasive methods allows for further differential diagnostic search only among the causes of the established type of pulmonary hypertension, which shortens the diagnostic pathway, saves time and costs for diagnosis and allows timely treatment.