One-Year Delay in Diagnosis Typical for Pulmonary Hypertension

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By Martha Kerr

CHICAGO (Reuters Health) Oct 24 - A study shows that most patients experience a one-year delay between the onset of symptoms and a confirmed diagnosis of pulmonary arterial hypertension (PAH), researchers reported here at CHEST 2007, the scientific assembly of the American College of Chest Physicians.

The ongoing REVEAL study (Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension Disease Management) is a large database of 1,226 patients with PAH. More than half (60%) have co-morbidities, including hypertension (32%), depression (14%), hypothyroidism (6%), scleroderma (15%) and diabetes (13%).

Dyspnea on exertion was present in 81% of patients, fatigue in 28%, chest pain or discomfort in 20% and edema in 20%. These were \"the most common symptoms attributable to PAH,\" said principal investigator Dr. C. Gregory Elliott of LDS Hospital in Salt Lake City, Utah.

Most patients presented to their physicians within one month of the appearance of symptoms, but the average time to being informed of a possible diagnosis of PAH was seven months.

Right heart catheterization for confirmation of the diagnosis was performed approximately 13 months after the appearance of symptoms and the first visit to a PAH clinic was 15 months, Dr. Elliott said. He added that \"a quarter of patients experience an even longer delay that approaches three years.\"

\"With the number of FDA-approved agents for treating PAH increasing yearly, shortening the time to start of treatment might have a significant impact on patient outcomes,\" Dr. Elliott observed.

http://www.medscape.com/viewarticle/564826