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).
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