Abstract
Pulmonary hypertension (PH) is a silent disease with many causes that comes to clinical attention late in its course. There are indirect features of PH found on noninvasive imaging studies, but the diagnosis of this disease and its therapeutic management still require right heart catheterization with pressure measurements of the pulmonary artery. In general, with chronic PH, the main pulmonary artery is enlarged, there is tapering of the peripheral pulmonary arteries, there is decreased vessel compliance from muscular hypertrophy of the arterial walls, and there is reduced pulmonary blood flow. This is accompanied by changes in the right heart including right ventricular (RV) hypertrophy, RV enlargement, RV dysfunction, and tricuspid regurgitation. In the acute setting, such as with massive pulmonary emboli, the abrupt change in pulmonary arterial pressure has a dramatic effect on right heart contractility. The peak velocity of the tricuspid regurgitation jet, as measured by echocardiography or MRI, is loosely correlated with pulmonary arterial pressure. Untreated PH results in a rapid clinical decline with death frequently occurring within 3 years of diagnosis. Even with treatment, the mean survival time is still less than 4 years.
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Schiebler, M.L., Runo, J., Jensen, L., François, C.J. (2012). Imaging of Pulmonary Hypertension. In: Kanne, J. (eds) Clinically Oriented Pulmonary Imaging. Respiratory Medicine. Humana Press. https://doi.org/10.1007/978-1-61779-542-8_9
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