European Radiology

, Volume 19, Issue 11, pp 2557–2568 | Cite as

Cardiac causes of pulmonary arterial hypertension: assessment with multidetector CT

  • Edward T. D. Hoey
  • Deepa Gopalan
  • S. K. Bobby Agrawal
  • Nicholas J. ScreatonEmail author


The causes of pulmonary arterial hypertension (PAH) are diverse and include multiple congenital and acquired cardiac diseases as well as diseases primarily affecting the pulmonary vasculature, lung, pleura and chest wall. The traditional role of CT in evaluating PAH includes assessment of pulmonary vasculature and lung parenchyma with limited assessment of the heart. Advances in multidetector CT technology with improved spatial and temporal resolution now permit accurate delineation of cardiac morphology. CT pulmonary angiography (CTPA) is widely utilised in the workup of patients with suspected pulmonary vascular disease and can identify both pulmonary and cardiac causes. As the initial presentation for CTPA is often precipitated by nonspecific, unexplained symptoms and therefore undertaken by a general radiologist, it is important that a systematic approach to the interpretation of these studies, including cardiac evaluation, is routinely adopted. This paper reviews the CT evaluation in pulmonary hypertension with a particular focus on the cardiac causes, their subclassification into congenital systemic to pulmonary shunts and secondary to left heart disease, and their imaging features. It emphasises the use of a systematic approach to interpretation of CTPA examinations both in patients with known PAH and those with previously unsuspected disease.


Multidetector computed tomography Cardiac Pulmonary arterial hypertension 


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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Edward T. D. Hoey
    • 1
  • Deepa Gopalan
    • 1
  • S. K. Bobby Agrawal
    • 1
  • Nicholas J. Screaton
    • 1
    • 2
    Email author
  1. 1.Papworth HospitalCambridgeUK
  2. 2.Diagnostic Centre, Department of RadiologyPapworth Hospital NHS TrustPapworth EverardUK

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