Pulmonary hypertension echocardiography or ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Richard Channick, M.D.; Assistant Editor(s)-in-Chief: Ralph Matar.

Overview

Echocardiography may demonstrate enlargement of the right chambers with a thickened interventricular septum in patients with pulmonary hypertension. Right ventricular afterload may be suggested by a leftward septal displacement during systole. Pericardial effusions and diminished left ventricular cavity typically portend a dismal prognosis.

Echocardiography

Once pulmonary hypertension is suspected in a patient, a transthoracic echocardiogram should be done to assess right heart function including:

Pulmonary arterial pressure
Tricuspid regurgitation
Increased velocity of pulmonary valve regurgitation and short acceleration time of right ventricle ejection into the pulmonary artery
Enlarged right heart chambers
Abnormal shape and function (displacement) of interventricular septum
Right ventricular wall hypertrophy
Dilated main pulmonary artery
Pericardial effusion
Doppler echocardiographic index (Tei index or myocardial performance index) which is the sum of both isovolumetric contraction and relaxation intervals, divided by the ejection time

Video showing Top 10 echocardiographic findings in moderate to severe pulmonary hypertension

Disclaimer: Adapted from Billy Cathey RDCS:Pulmonary hypertension 2D findings: {{#ev:youtube|3yOdNyTH07g}} Abbreviations:

RVE: Right ventricular enlargement
RVH: Right ventricular hypertrophy
RAE: Right atrial enlargement
TR: Tricuspid regurgitation
PFO: Patent foramen ovale
RVSP: Right ventricular systolic pressure
SPAP: Systolic pulmonary artery pressure
RVOT: Right ventricular outflow tract
IVC: Inferior vena cava

The 2009 Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT)^[1]

References

↑ Galiè N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA; et al. (2009). "Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT)". Eur Heart J. 30 (20): 2493–537. doi:10.1093/eurheartj/ehp297. PMID 19713419.

Template:WikiDoc Sources

[pmid19713419-1] Galiè N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA; et al. (2009). "Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT)". Eur Heart J. 30 (20): 2493–537. doi:10.1093/eurheartj/ehp297. PMID 19713419.

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