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:

1. Pulmonary arterial pressure.
2. Tricuspid regurge.
3. Increased velocity of pulmonary valve regurge and short acceleration time of right ventricle ejection into the pulmonary artery.
4. Enlarged right heart chambers.
5. Abnormal shape and function (displacement) of interventricular septum.
6. Right ventricular wall hypertrophy.
7. Dilated main pulmonary artery.
8. Pericardial effusion.
9. Doppler echocardiographic index (Tei index or myocardial performance index) which is the sum of both isovolumetric contraction and relaxation intervals, divided by 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 regurge.
• PFO:Patent foramen ovale
• RVSP:Right ventricular systolic pressue.
• SPAP:Systolic pulmonary artery pressure.
• RVOT:Right ventricular outflow tract.
• IVC:Inferior vena cava