"Guiding lights" for the diagnosis of chronic thromboembolic pulmonary hypertension in the flow of patients with pulmonary embolism

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Abstract

On December 13, 2021, an expert council was held to determine the position of experts of different specialties regarding the reasons for the low level of diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) in real clinical practice in a pandemic of a new coronavirus infection and possible ways to improve detection in patients with pulmonary embolism (PE) ) in history. The reasons for the low level of diagnosis of CTEPH are the insufficient level of knowledge of specialists, especially primary care physicians; lack of clear regulatory documents and expert centers for the management of this category of patients. Primary diagnosis of CTEPH in a pandemic can be strengthened through the widespread use of telemedicine for consultations of primary care physicians with specialists from expert centers; to maximize the role of echocardiography and computed tomography (CT) as differential diagnostic tools for dyspnea, in particular in patients with COVID-19. To increase the detection rate of CTEPH, diagnostic vigilance is required in patients with risk factors and episodes of venous thromboembolism. To improve the screening of CTEPH, it is necessary to create an algorithm for monitoring patients who have had PE; provide educational activities, including through the media; create materials for patients with accessible information. The regulatory documents should designate the circle of responsible specialists who will be engaged in long-term monitoring of patients with PE. Educational programs are needed for primary care physicians, cardiologists, and other physicians who come into the field of view of patients with CTEPH; introduction of a program to create expert centers for monitoring and managing patients with the possibility of performing ventilation-perfusion lung scintigraphy, cardiopulmonary stress test, CT, right heart catheterization. It seems important to build cooperation with the Ministry of Health of Russia in order to create special protocols, procedures for managing patients with PE and CTEPH.

About the authors

Irina E. Chazova

Chazov National Medical Research Center of Cardiology

Email: trukhiniv@mail.ru
ORCID iD: 0000-0002-9822-4357

акад. РАН, д-р мед. наук, проф., зам. ген. дир. по научно-экспертной работе, рук. отд. гипертонии

Russian Federation, Moscow

Tamila V. Martynyuk

Chazov National Medical Research Center of Cardiology; The Russian National Research Medical University named after N.I. Pirogov

Author for correspondence.
Email: trukhiniv@mail.ru
ORCID iD: 0000-0002-9022-8097

д-р мед. наук, рук. отд. легочной гипертензии и заболеваний сердца Института клинической кардиологии им. А.Л. Мясникова; проф. каф. кардиологии фак-та дополнительного профессионального образования

Russian Federation, Moscow; Moscow

Sergey V. Gorbachevskii

Bakoulev Scientific Center for Cardiovascular Surgery; Russian Medical Academy of Continuous Professional Education

Email: trukhiniv@mail.ru
ORCID iD: 0000-0002-4193-3320

д-р мед. наук, проф., зав. отд-нием хирургического лечения заболеваний сердца с прогрессирующей легочной гипертензией; проф. каф. сердечно-сосудистой хирургии

Russian Federation, Moscow; Moscow

Vladimir V. Gramovich

Chazov National Medical Research Center of Cardiology

Email: trukhiniv@mail.ru
ORCID iD: 0000-0003-3292-0912

канд. мед. наук, ст. науч. сотр. отд. легочной гипертензии и заболеваний сердца Института клинической кардиологии им. А.Л. Мясникова

Russian Federation, Moscow

Nikolay M. Danilov

Chazov National Medical Research Center of Cardiology

Email: trukhiniv@mail.ru
ORCID iD: 0000-0001-9853-9087

д-р мед. наук, вед. науч. сотр. отд. гипертонии Института клинической кардиологии им. А.Л. Мясникова

Russian Federation, Moscow

Elizaveta P. Panchenko

Chazov National Medical Research Center of Cardiology

Email: trukhiniv@mail.ru
ORCID iD: 0000-0002-1174-2574

д-р мед. наук., проф., рук-ль отд. клинических проблем атеротромбоза

Russian Federation, Moscow

Aleksandr M. Chernyavskiy

E. Meshalkin National Medical Research Center

Email: trukhiniv@mail.ru
ORCID iD: 0000-0001-9818-8678

чл.-кор. РАН, д-р мед. наук, проф., рук-ль Центра кардиохирургии аорты и коронарных артерий

Russian Federation, Novosibirsk

Anton A. Shmalts

Bakoulev Scientific Center for Cardiovascular Surgery; Russian Medical Academy of Continuous Professional Education

Email: trukhiniv@mail.ru
ORCID iD: 0000-0001-8937-1796

д-р мед. наук, вед. науч. сотр. отд-ния хирургического лечения заболеваний сердца с прогрессирующей легочной гипертензией; доц. каф. сердечно-сосудистой хирургии

Russian Federation

Igor S. Yavelov

National Medical Research Center for Therapy and Preventive Medicine

Email: trukhiniv@mail.ru
ORCID iD: 0000-0003-2816-1183

д-р мед. наук, проф., вед. науч. сотр. отд. клинической кардиологии и молекулярной генетики, рук. отд. фундаментальных и клинических проблем тромбоза при неинфекционных заболеваниях

Russian Federation, Moscow

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