Pulmonary hypertension chest x ray: Difference between revisions

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{{Pulmonary hypertension}}
{{Pulmonary hypertension}}
{{CMG}}, Richard Channick, M.D.; '''Assistant Editor(s)-in-Chief:''' [[User:Ralph Matar|Ralph Matar]].
{{CMG}}, Richard Channick, M.D.; '''Assistant Editor(s)-in-Chief:''' [[User:Ralph Matar|Ralph Matar]]; {{Jose}}
==Overview==
==Overview==
*Chest x-ray is abnormal in 90% of patients with pulmonary hypertension at the time of diagnosis. However, no correlation have been found between the degree of severity of pulmonary hypertension and the findings on chest x-rays.


*It allows exclusion of moderate to severe lung diseases and pulmonary venous hypertension due to left heart disease.
A [[chest X-ray]] is abnormal in the majority of patients with pulmonary hypertension (PH); however, there is no correlation between the severity of PH and the findings on a chest X-ray. Findings of PH on a [[chest X-ray]] include [[pulmonary artery]] dilatation and right-sided enlargement of the heart.  A [[chest X-ray]] may suggest that there is no compromise of the left heart if normal and allows for initial assessment of lung disease that can lead to group 2 and group 3 PH, respectively.


==Chest X Ray==
==Chest X Ray==
===Findings on Chest x-ray===
Findings of PH on a chest X-ray include:<ref name="pmid26552229">{{cite journal |vauthors=Korobkova IZ, Lazutkina VK, Nizovtsova LA, Riden TV |title=[Radiographic assessment of pulmonary hypertension: Methodical aspects] |language=Russian |journal=Vestn Rentgenol Radiol |volume= |issue=4 |pages=45–53 |date=2015 |pmid=26552229 |doi= |url=}}</ref><ref name="pmid24311231">{{cite journal |vauthors=Pienn M, Kovacs G, Tscherner M, Avian A, Johnson TR, Kullnig P, Stollberger R, Olschewski A, Olschewski H, Bálint Z |title=Non-invasive determination of pulmonary hypertension with dynamic contrast-enhanced computed tomography: a pilot study |journal=Eur Radiol |volume=24 |issue=3 |pages=668–76 |date=March 2014 |pmid=24311231 |doi=10.1007/s00330-013-3067-8 |url=}}</ref><ref name="pmid23912192">{{cite journal |vauthors=Cordova FC, D'Alonzo G |title=Sarcoidosis-associated pulmonary hypertension |journal=Curr Opin Pulm Med |volume=19 |issue=5 |pages=531–7 |date=September 2013 |pmid=23912192 |doi=10.1097/MCP.0b013e328363f4a3 |url=}}</ref>
# [[Hilar]] pulmonary arterial dilation.
* [[Hilar]] pulmonary arterial dilation
# Loss of peripheral blood vessel markings.
* Loss of peripheral blood vessel markings
# Enlarged right atrium and right ventricle in advanced diseases.
* Enlarged right atrium, right ventricle and [[pulmonary arteries]] in advanced diseases.<ref name="pmid33844574">{{cite journal| author=Poch D, Mandel J| title=Pulmonary Hypertension. | journal=Ann Intern Med | year= 2021 | volume= 174 | issue= 4 | pages= ITC49-ITC64 | pmid=33844574 | doi=10.7326/AITC202104200 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33844574  }} </ref>
 
===Typical chest x-rays===


Shown below are chest X-ray images of patients with PH.
<gallery>
<gallery>
Image:336139-361242-1175.jpg|This is a posteroanterior radiograph revealing enlarged pulmonary arteries in a patient with [[Atrial septal defect]].
Image:336139-361242-1175.jpg|This is a posteroanterior radiograph revealing enlarged pulmonary arteries in a patient with [[atrial septal defect]].
Image:Pulmon4.gif
Image:Pulmon4.gif
Image:CXR for a patient with advanced [[Histiocytosis X]] associated with severe pulmonary hypertension.jpeg|Chest x-ray for a patient with advanced Histiocytosis X associated with severe pulmonary hypertension
Image:CXR for a patient with advanced [[Histiocytosis X]] associated with severe pulmonary hypertension.jpeg|Chest x-ray for a patient with advanced Histiocytosis X associated with severe pulmonary hypertension
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Latest revision as of 13:31, 9 June 2021

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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; José Eduardo Riceto Loyola Junior, M.D.[2]

Overview

A chest X-ray is abnormal in the majority of patients with pulmonary hypertension (PH); however, there is no correlation between the severity of PH and the findings on a chest X-ray. Findings of PH on a chest X-ray include pulmonary artery dilatation and right-sided enlargement of the heart. A chest X-ray may suggest that there is no compromise of the left heart if normal and allows for initial assessment of lung disease that can lead to group 2 and group 3 PH, respectively.

Chest X Ray

Findings of PH on a chest X-ray include:[1][2][3]

  • Hilar pulmonary arterial dilation
  • Loss of peripheral blood vessel markings
  • Enlarged right atrium, right ventricle and pulmonary arteries in advanced diseases.[4]

Shown below are chest X-ray images of patients with PH.

References

  1. Korobkova IZ, Lazutkina VK, Nizovtsova LA, Riden TV (2015). "[Radiographic assessment of pulmonary hypertension: Methodical aspects]". Vestn Rentgenol Radiol (in Russian) (4): 45–53. PMID 26552229.
  2. Pienn M, Kovacs G, Tscherner M, Avian A, Johnson TR, Kullnig P, Stollberger R, Olschewski A, Olschewski H, Bálint Z (March 2014). "Non-invasive determination of pulmonary hypertension with dynamic contrast-enhanced computed tomography: a pilot study". Eur Radiol. 24 (3): 668–76. doi:10.1007/s00330-013-3067-8. PMID 24311231.
  3. Cordova FC, D'Alonzo G (September 2013). "Sarcoidosis-associated pulmonary hypertension". Curr Opin Pulm Med. 19 (5): 531–7. doi:10.1097/MCP.0b013e328363f4a3. PMID 23912192.
  4. Poch D, Mandel J (2021). "Pulmonary Hypertension". Ann Intern Med. 174 (4): ITC49–ITC64. doi:10.7326/AITC202104200. PMID 33844574 Check |pmid= value (help).

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