The Trouble with Group 3 Pulmonary Hypertension in Interstitial Lung Disease: Dilemmas in Diagnosis and the Conundrum of Treatment.

The Trouble with Group 3 Pulmonary Hypertension in Interstitial Lung Disease: Dilemmas in Diagnosis and the Conundrum of Treatment. Chest. 2020 May 06;: Authors: King CS, Shlobin OA Abstract Pulmonary hypertension due to interstitial lung disease (PH-ILD) can complicate a multitude of interstitial lung diseases including idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonitis, and non-specific interstitial pneumonitis. Development of PH-ILD is associated with increased need for supplemental oxygen, reduced mobility, and decreased survival. A high index of suspicion is required to make the diagnosis given the substantial overlap in symptoms with those of interstitial lung disease without PH. Severely reduced diffusing capacity or six-minute walk test distance, prominent exertional desaturation and impaired heart rate recovery following exercise are all suggestive of the development of PH-ILD. Traditional transthoracic echocardiography (TTE) is the most commonly employed screening test for PH-ILD but it lacks sensitivity and specificity. Newer echocardiograpahic tools employing 3D assessment of the right ventricle may have a role in both prognosis and monitoring of patients with PH-ILD. Right heart catheterization remains the gold standard for confirming a diagnosis of PH-ILD. While there is little debate over the use of supplemental oxygen and diuretic therapy in the treatment of PH-ILD, treatment with pulmonary vasodilato...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research