Thromboembolic Pulmonary Hypertension

Report:

Sinus tachycardia 110/min

Right atrial abnormality

Right axis deviation +160o

Right ventricular hypertrophy with ST/T changes

Suggestive of cor pulmonale

Comment:

Everything supports RVH here. This one has a relatively unusual ætiology: chronic thromboembolic pulmonary hypertension41. The diagnostic angiography also showed pulmonary artery pressure of 95 mm, indicating chronicity of pulmonary emboli (RV has to hypertrophy to generate that kind of pressure). Echocardiography confirmed enlarged RA and RV, with normal LV.

The RAA is a real P pulmonale of old, rarely seen like this in pulmonary vascular disease, but common in chronic airway obstruction with cor pulmonale.

A tracing taken 5 months previously is almost identical (Fig 37a).

If you have any suggestions for or feedback on this report, please let us know.