Editorial |

Extensive Slow-Flow Vascular Malformations and Pulmonary Hypertension

Eduard J. van Beers, MD; Renée A. Douma, MD, PhD; Charlène E. U. Oduber, MD; Victor E. A. Gerdes, MD, PhD; Chantal M. A. M. van der Horst, MD, PhD; Paul Bresser, MD, PhD
Arch Dermatol. 2010;146(12):1416-1418. doi:10.1001/archdermatol.2010.377.
Text Size: A A A
Published online


Recent case reports have recognized chronic thromboembolic pulmonary hypertension (CETPH) as an important complication of slow-flow vascular malformations.17 This month's issue of the Archives features the first case-control study exploring the prevalence of pulmonary hypertension (PH) in patients with extensive slow-flow vascular malformations.

In the presented case-control study, Rodríguez-Mañero et al8 evaluated 32 asymptomatic patients with extensive slow-flow vascular malformations (involving at least 15% of the body surface area) for evidence of PH using transthoracic echocardiography. Their most important finding is that in 22% of these patients the estimated pulmonary arterial systolic pressure (PASP) was 50 mm Hg or higher. Although the authors did not perform catheterization of the right side of the heart to confirm or rule out the presence of PH in their patients, this implies that in a considerable number of patients the diagnosis of PH is very likely.9 Moreover, another 50% of the evaluated patients had estimated PASP values of 37 to 50 mm Hg, which suggests that a diagnosis of PH is very possible. Thus, following international guidelines for diagnosis and treatment of PH in as many as 72% of the patients evaluated, further diagnostic workup is warranted.9,10

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption

Clinical classification of pulmonary hypertension. (Simonneau et al11). ALK1 indicates activin receptor-like kinase type 1; BMPR2, bone morphogenetic protein receptor type 2; HIV, human immunodeficiency virus; and PAH, pulmonary arterial hypertension.

Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles