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Vol. 45. Issue S6.
Hipertensión pulmonar tromboembólica crónica
Pages 15-20 (June 2009)
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Vol. 45. Issue S6.
Hipertensión pulmonar tromboembólica crónica
Pages 15-20 (June 2009)
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Diagnóstico clínico y hemodinámico de la hipertensión pulmonar tromboembólica crónica
Clinical and hemodynamic diagnosis in chronic thromboembolic pulmonary hypertension
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Isabel Blanco
Corresponding author
iblanco2@clinic.ub.es

Autor para correspondencia.
, Joan Albert Barberà
Servei de Pneumologia i Al.lèrgia Respiratoria, Institut Clínic del Tórax, Hospital Clínic de Barcelona, Barcelona, España
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El diagnóstico de hipertensión pulmonar tromboembólica crónica (HPTEC) se fundamenta en el cuadro clínico, la demostración de lesiones obstructivas en las arterias pulmonares y la evaluación hemodinámica. El proceso diagnóstico engloba distintos elementos, que van desde la sospecha clínica hasta la confirmación definitiva mediante exámenes complejos que incluyen la angiografía y el estudio hemodinámico pulmonar. Una vez establecido el diagnóstico de HPTEC, determinar si el paciente es candidato a endarterectomía pulmonar conlleva estudios adicionales y una evalución multidisciplinar, que debe llevarse a cabo en centros con experiencia en dicha cirugía. En el presente capítulo se revisan los procedimientos utilizados para establecer el diagnóstico de HPTEC así como las exploraciones que permitirán identificar los candidatos al tramiento quirúrgico de la HPTEC.

Palabras clave:
Tromboembolismo pulmonar
Hipertensión pulmonar tromboembólica crónica
Estudio hemodinámico pulmonar
Vasorreactividad
Algoritmo diagnóstico
Presión arterial pulmonar
Abstract

Diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) is based on the clinical picture, the presence of obstructive lesions in the pulmonary arteries and hemodynamic evaluation. The diagnostic process encompasses distinct elements ranging from clinical suspicion to definitive confirmation through complex examinations including angiography and pulmonary hemodynamic studies. Patients with an established diagnosis of CTEPH should be evaluated for pulmonary endarterectomy, requiring additional studies and multidisciplinary assessment, which should be performed in centers with experience of this type of surgery. The present article reviews the procedures used to establish the diagnosis of CTEPH, as well as the procedures that allow candidates for surgical treatment of this disease to be identified.

Keywords:
Pulmonary thromboembolism
Chronic thromboembolic pulmonary hypertension
Pulmonary hemodynamic study
Vasoreactivity
Diagnostic algorithm
Pulmonary artery pressure
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Copyright © 2009. Sociedad Española de Neumología y Cirugía Torácica
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