PubMed · 9047481
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T Kawara, K Hiejima. 1996. [Intraatrial block].. https://pubmed.ncbi.nlm.nih.gov/9047481/
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The onset of pulmonary hypertension in patients with systemic sclerosis carries a poor prognosis. Atrial septostomy has been used successfully to palliate endstage primary pulmonary hypertension but has not been attempted in other forms of pulmonary vascular disease. We report substantial clinical improvement following atrial septostomy in a patient with systemic sclerosis complicated by severe, isolated pulmonary hypertension. After the procedure, exercise capacity was improved and exertional syncope abolished. We suggest that this procedure should be considered for other patients with this diagnosis.
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The assessment of cardiovascular hemodynamics is an extremely important component of managing patients with cardiac diseases. For years, this has been accomplished primarily through the use of right and left heart catheters placed within the cardiac chambers. Since this is an invasive technique, it should only be used when necessary; patient discomfort, infections, and overall risks for physicians would be reduced if noninvasive methods were utilized when available. Echocardiography (echo) provides the greatest ability to determine cardiovascular hemodynamics noninvasively, but requires the utmost precision and care to avoid misinterpretation. When used correctly, echocardiographic modalities provide an even greater assessment of the cardiac patient than invasive techniques. A safer and more comprehensive interpretation is available, and thus, echo should be considered the modality of choice-the new gold standard.