Prior to any new patient receiving an appointment at the National Pulmonary Hypertension Unit, all pertinent medical records from the referring physician must be faxed to 01 8032852. The information is then reviewed by Professor Gaine and a scheduled appointment date will be sent in writing to the Patients address. The waiting time for consultation is 4-6 weeks and appointments are scheduled based on priority. If a new patient is currently in hospital at the time of referral, the referring team are contacted to arrange an appointment date and transport to the Pulmonary Hypertension clinic.
If you currently attend the Pulmonary Hypertension Unit, you will typically receive a 3 monthly follow-up appointment.
For all appointments:
The pulmonary Hypertension clinic is very busy, and reviews a large number of patients each week. Your appointment is very important to us and it is extremely important that you keep your appointment date and time. In the case that you need to reschedule, please contact the Pulmonary Hypertension secretary on 01 8034420 as soon as possible. This will allow us time to arrange for another patient who is on the waiting list to be reviewed at the clinic.
Referral to the Pulmonary Hypertension Unit should typically be made following completion of the following investigations
1. Electrocardiograph (ECG)
2. Chest X Ray (CXR)
3. Pulmonary Function tests (PFT`s)
4. A demonstration of Pulmonary Hypertension on Echocardiograph (Echo)
5. A Ventilation Perfusion Scan (VQ Scan)
6. If the VQ Scan is suggestive of clot then it is necessary to perform a CT Pulmonary Angiogram.
Note: A right Heart Catheterization is the definitive tool in confirming diagnosis of Pulmonary Hypertension. This should only be performed following referral to the Pulmonary Hypertension Unit, where vaso-reactivity testing can be performed.
On the clinic visit the patient will be reviewed by the physician.
A full clinical history and examination will take place
A six-minute walk test will be performed (always wear comfortable shoes to clinic appointments)
Any additional blood tests will be taken.
The patient will have a consultation with the nurse specialist and a history of clinical symptoms will be taken and discussed. This will provide an invaluable opportunity for the patient and family to ask questions or discuss concerns regarding diagnosis, treatment and follow-up appointments.
Following your first visit as a new referral, objectives and priorities for investigation will be ascertained. If further investigations are necessary before confirmation of the disease can be made, an appointment date for admission will be discussed and confirmed in writing.
Typically all persons are admitted to St. Johns Ward in the Mater Hospital. Here the staff and ward managers are skilled in looking after patients with Pulmonary Hypertension. The waiting ist for admission is operated on a priority basis; this is based on the person’s clinical condition at that time. During this admission period any out standing investigations will be performed, diagnosis given and the appropriate disease specific treatment initiated. Treatment initiation may require a period in hospital to allow monitoring for drug tolerance and suitability.
Patients are generally seen for follow up examination in the clinic one month after treatment initiation and then every 3 months, depending on response to treatment. All persons attending the Pulmonary Hypertension Unit are advised to contact the Pulmonary Hypertension Nurse Specialists to report any symptoms / side effects or should any problems arise. The amount of contact depends on the stability of the patient and overall comfort level. During follow up telephone surveillance, new or worsening symptoms should prompt an additional visit to the clinic for evaluation.
A right heart catheterisation is typically performed after one year of therapy.
Right -heart catheterisation is the gold standard for assessment of pulmonary haemodynamics. The expectation at one year should be improvement in pulmonary pressures, but not typically normalisation of them.
Echo evaluation after approximately 3-6 months of treatment can provide a useful interim estimation of pulmonary pressures and can provide useful information on how the heart is dealing with the high pressures.
The national pulmonary hypertension unit (NPHU) at the Mater Misericordiae Hospital, Dublin was established in 2003, as a national referral and treatment centre for those diagnosed with PH in Ireland. It was officially opened as a National Centre by the Patron of the Pulmonary Hypertension Association, President Mary McAleese in 2006.
Current international guidelines recommend that the management of pulmonary hypertension (PH) should take place in designated specialist centres, where expert care can be provided at the correct stage of the disease process.
There are seven specialist centres in Great Britain, one in Scotland and one in the Republic of Ireland, all of which are designated to treat pulmonary hypertension. These form the association of PH centres of Great Britain and Ireland.
The Pulmonary Hypertension program at the Mater Hospital participates in numerous multi-center clinical trials for treatment of PAH. Thus, it also has the facility to provide promising investigational drugs to appropriate patients with PAH.