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Algorithm for evaluation of pulmonary hypertension related to sickle cell disease

Algorithm for evaluation of pulmonary hypertension related to sickle cell disease
Proposed algorithm for evaluation of PH related to SCD.

6MWD: 6-minute walk distance; ANA: anti-nuclear antibody; EKG: electrocardiogram; HIV: human immunodeficiency virus; LFTs: liver function tests; mPAP: mean pulmonary artery pressure; NT-pro-BNP: N-terminal pro-brain natriuretic peptide; PAH: pulmonary artery hypertension; PAWP: pulmonary artery wedge pressure; PH: pulmonary hypertension; PVR: pulmonary vascular resistance; SCD: sickle cell disease; TRV: tricuspid regurgitant jet velocity.

* The use of the term screening refers to mortality risk assessment. Echocardiography should be performed while patients are clinically stable. Patients with an mPAP between 20 and 25 mmHg need further study as they may be at increased mortality risk. Note: PAH therapy is to be considered on the basis of a weak recommendation and very low-quality evidence.

¶ mPAP limits updated to currently-defined levels for this publication.
Adapted from: Klings ES, Machado RF, Barst RJ, et al, 2014. An official American Thoracic Society clinical practice guideline: diagnosis, risk stratification, and management of pulmonary hypertension of sickle cell disease. American Journal of Respiratory and Critical Care Medicine; 189:727. Official Journal of the American Thoracic Society. Reprinted with permission of the American Thoracic Society. Copyright © 2014 American Thoracic Society.
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