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The 18 Recommended Diagnostic Tests for Infant Pulmonary Hypertension


Many newborns are born with pulmonary hypertension and they are unable to breathe on their own upon arrival at the hospital.

This is particularly a problem for preemies since they're often born several weeks before full gestation, which means they may not have enough lung development to absorb enough oxygen even after receiving treatment.

While there isn't much that parents can do about genetic causes of the disease, steps can be taken to manage a newborn's case of pulmonary hypertension.

If your child has increased heart rate, shortness of breath, and cyanosis, you should consult your doctor.

Your doctor may perform tests to diagnose the condition. If your child does have pulmonary hypertension, your doctor will find the best diagnosis and treatment methods for your baby.

infant pulmonary hypertension

In our previous article, we did a comprehensive walkthrough on the risk factors and symptoms of pulmonary hypertension. If you missed that, you can always get it here.

However, we do suggest you go through the risk factors and symptoms of an infant's pulmonary hypertension first before reading about its possible diagnoses in this article.

Now, let’s see what we have for you.


Below are a number of diagnoses for infant pulmonary Hypertension depending on the symptoms.

1. Ventriculography

Ventriculography (VNG) is a diagnostic tool that measures the pressure in the blood vessels in the lungs.

VNG is often used in the early stages of pulmonary hypertension to determine whether an infant's blood flow is affected.

VNG can help diagnose the following: pulmonary artery prolapses, ventricular septal defect, and gallbladder disease.

VNG testing requires that the infant remain still while the doctor uses a catheter to insert a tiny camera into the lungs.

Once the camera is in place, the doctor measures the pressure and flow of blood through the lungs with the help of ultrasound.

2. Determine the Presence of VSD or PDA

VSD is a hole in the heart, which can be as small as 1 mm, or as large as 4 mm. VSD is often seen in preterm babies, and it is present in babies with trisomy 21, also known as Down syndrome.

PDA is a hole in the wall between the two lower chambers of the heart. It can be present at birth, or it may develop later, often due to heart defects or surgical complications.

If there are any problems with the heart's natural pumping ability, it will cause the heart to pump blood very slowly or not at all.

This can cause the blood pressure to rise in the lungs and cause the blood vessels to narrow.

3. Chest Radiograph

A chest x-ray is the best way to diagnose Infant Pulmonary Hypertension. A chest x-ray is the best way to diagnose infant pulmonary hypertension.

Doctors can perform a chest x-ray if they suspect that a newborn has pulmonary hypertension.

This can be done during a routine hospital check-up or in response to any of the following symptoms: a small raised, red mark on the baby's skin, chest discomfort lethargy, an abnormally rapid heartbeat, and fever.

infant pulmonary hypertension
4. Echocardiography

A doctor may use an ultrasound scan to see blood vessels. The doctor may be able to tell that a baby has pulmonary hypertension if they have an electrocardiogram (also called an echocardiogram) after they are born.

An echocardiogram takes pictures of the heart, which shows a specialized image of the blood flow in the baby's heart.

This can be used to see that the heart has narrowed and thickened, or that the valves in the heart has widened.

Echocardiograms are usually performed within two days after a baby is born. This will help the doctor determine the cause of Infant Pulmonary Hypertension.

5. Pulse Oximeter

To measure the levels of oxygen and carbon dioxide in the blood, a pulse oximeter is used.

In some cases, the doctor may advise a person to take their pulse at a different time of day to see if this different measure can help them identify the cause of their high blood pressure.

A person can also have high blood pressure while they are asleep and the morning blood pressure is normal.

A blood pressure reading in a doctor's office may not be accurate. Typically, the doctor will send a blood pressure reading to a laboratory for analysis.

For diagnosis, the blood pressure levels must be confirmed by a doctor.

infant pulmonary hypertension

6. Chest CT-Scan

Most cases of infant pulmonary hypertension is detected in the hospital or clinic settings.

At birth, the lungs of the newborn are small and immature. They are difficult to examine and diagnose, as they cannot produce adequate amounts of new blood vessels or capillaries to carry oxygen around the lungs and bloodstream.

As a result, it is possible for the lungs to be unable to properly oxygenate the blood.

infant pulmonary hypertension
7. Inpatient Workup

An outpatient workup will not always be required for the diagnosis of infant pulmonary Hypertension.

However, it is important to rule out some possible causes of the condition.

It may be possible to use an outpatient workup to check for a different cause of the blood pressure, such as subglottic stenosis or bronchiectasis.

In the outpatient workup, the doctor will ask the parents about any recent illnesses or if the baby had undergone any kind of surgery.

8. Aortic Arch Measurement by Magnetic Resonance Imaging

The aortic arch is the bony opening in the heart that is formed by the aortic valve. It is located in the upper left chest, right below the collarbone.

The diagnosis of infant pulmonary Hypertension is usually made by measuring the aortic arch length in the chest.

The measurement typically shows abnormalities in the aortic arch that can indicate an infant pulmonary Hypertension.

Doctors can use magnetic resonance imaging (MRI) to measure the aortic arch.

Magnetic resonance imaging (MRI) is a type of diagnostic imaging that uses strong magnetic fields to produce images of body parts. MRI can provide images of the aortic arch. Before MRI, doctors typically perform an echocardiogram or an ultrasound of the heart.

9. Health History of the Parents and Siblings

A newborn's medical history, blood tests, and physical exams are vital for diagnosing pulmonary hypertension.

The following medical histories are available when looking for Infant Pulmonary Hypertension:

When doctors examine the newborn, they may ask about any medical conditions the baby might have or if there are any family members or relatives with similar problems.

Doctors will also ask about the health history of the baby's parents and siblings.

By knowing a newborn's medical history, doctors can rule out other health problems and figure out the cause of the condition.

10. Genetics Counselling

Only around 4% of babies are affected by this condition, but up to 8% of cases are hereditary

since the cause of infants' pulmonary hypertension is not yet fully understood.

Genetic counselling and medical genetic testing can help a doctor determine if there is a genetic link to this condition.

The main genetic risk factors for this condition are: red blood cell disorders, congenital diaphragmatic hernia, multifocal leukoencephalopathy (MLH), and autosomal dominant red cell disorders.

11. Electrocardiography (ECG)

Auscultation and electrocardiography is the main diagnostic tool for infant pulmonary hypertension.

ECG will be carried out on an infant who has a possible case of pulmonary hypertension, to check for abnormalities.

An electrocardiogram (ECG) uses the heart and electrical signals to check the heart's movement. This allows the doctors to check for abnormal heart rhythms.

Although auscultation is a less accurate tool, it is easier to perform. It is used to check for a problem, rather than to diagnose a problem.

Auscultation is often used to rule out or confirm a diagnosis of other conditions, such as sepsis.

infant pulmonary hypertension
12. Stress Test

A stress test involves placing the baby on a stretcher and giving the baby small doses of a substance that causes the baby's heart to beat faster and faster until it collapses.

This is to see if there is an underlying heart defect. Once a baby has been diagnosed with pulmonary hypertension, a doctor will prescribe the appropriate medications and ask about the lifestyle and family history of the mother and child.

Doctors typically recommend that newborns be put on medications that will help the heart keep a healthy blood flow to the lungs.

Once a baby is stable on the medications, the doctor will monitor them closely to make sure that they are keeping the heart healthy and in a normal rhythm.

13. Arterial Blood Gas Analysis

A medical device called a blood gas test can help diagnose infant pulmonary hypertension.

An arterial blood gas (ABG) is a test that measures the function of the lungs. The test identifies if the flow of blood to the lungs is sufficient to allow oxygen to be carried through the bloodstream.

A good ABG will show a low oxygen saturation, which may indicate pulmonary hypertension.

This diagnosis can be further helped by testing for infectious diseases in the blood or tissues.

Common infectious diseases like Pertussis. this disease is caused by the bacterium Bordetella pertussis. It is transmitted through the air and usually affects infants.

14. Right Heart Catheterisation

This procedure involves threading a catheter through an artery, vein, or vein in the groin to the right side of the heart.

The catheter then leads to a vein at the chest that feeds the right side of the heart with blood, which the right ventricle (the heart's main pumping chamber) uses to produce pressure to circulate the blood around the body.

This helps keep the blood oxygenated. When a blood vessel collapses, as is the case with pulmonary hypertension, the right ventricle is unable to pump blood around the body.

In a right heart catheterization, a doctor will make a small hole at the entrance of the right ventricle to allow blood to drain away from the lungs.

Then, they will insert a tube into the right ventricle and guide it to the pulmonary artery.

15. Pulmonary Function Tests

Pulmonary function tests are used to monitor the health of the lungs in newborns. All babies are born with a low amount of blood in the lungs.

The amount of blood in the lungs affects how well they breathe. When a baby is born, the lungs can respond to the hormone Oxytocin.

Oxytocin causes more blood to enter the lungs, and this helps them adjust to the changes in air pressure that occur when a baby is born.

During the first several hours after birth, the lungs continue to adapt to their new environment.

16. Liver and Renal Function Test

A doctor may diagnose a medical condition in a newborn based on their blood tests.

An early sign of infant pulmonary Hypertension is when they have severe jaundice or an elevated liver-to-kidney ratio.

They may also have low levels of oxygen and blood pressure. As the blood flows through the baby's body, it is clear that the baby has low blood volume.

These low levels of blood mean that the tissues in the body do not get enough oxygen.

Early diagnosis of a pulmonary hypertension condition in newborns can help doctors prevent damage to the lungs and blood vessels.

infant pulmonary hypertension
17. Hyperoxia Test

An oximeter is a small device that measures oxygen saturation in the blood. It can be used to help diagnose infant pulmonary hypertension.

The oximeter may be used in combination with a bronchopulmonary reflex test, also known as the hyperoxia test.

The test is usually carried out on a neonate who is being checked for anaemia or the presence of any additional illnesses.

The idea behind the test is that the oximeter allows a doctor to see the amount of oxygen that is being delivered to the bloodstream.

The test is carried out in a neonatal intensive care unit (NICU).

18. Foetal Echo Diagnosis

The foetal echo is a prenatal blood test used to detect diseases. It is a special blood test that is carried out to detect diseases, especially congenital heart disease.

This test is usually carried out in the second and third trimesters of pregnancy. The foetus can be examined with an ultrasound machine to make sure that it has a healthy heart structure.

This scan will tell the doctor how well the baby's heart is functioning and how well the baby is growing.

If a foetus has a serious disease, doctors may perform an amniocentesis to get a diagnosis.

infant pulmonary hypertension

The development of Infant pulmonary hypertension is ongoing and it's a complicated process that is still not understood.

As with any disease, it is important for you to know everything about the disease and the symptoms, as well as the prognosis and the correct diagnosis of the disease.

The first step towards getting the right diagnosis is to take your baby to the doctor to get it checked.

The doctor will listen to the baby's chest with a stethoscope to check for congestion, wheezing or crackling sounds, and other abnormal pulmonary sounds.

The doctor may also take the baby's blood pressure to check if it's high and as well may take an echocardiogram of the baby's heart to check for heart defects.

Sometimes the doctor may also take the baby's chest X-ray or CT scan to get a better look at the lungs.

If your baby is diagnosed with pulmonary hypertension, then the doctor will treat it with medications or recommend that you consult a specialist like a cardiologist or a pulmonologist who will be able to attend to your case.

We hope that the information we provided in this blog post has been helpful for you, and we wish you the best with your infant pulmonary hypertension.

Remember to check back as we shall soon bring out the best treatment options for this disease.



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