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What is the best approach to a high systolic pulmonary artery pressure on echocardiography?

Mostafa Ahmed, MD, Raed A. Dweik, MD and Adriano R. Tonelli, MD
Cleveland Clinic Journal of Medicine April 2016, 83 (4) 256-260; DOI: https://doi.org/10.3949/ccjm.83a.14186

Article Figures & Data

Figures

  • FIGURE 1
    FIGURE 1

    An algorithmic approach to the assessment of systolic pulmonary artery pressure on echocardiography.

    Adapted in part from the diagnostic approach to pulmonary hypertension recommended by the Fifth World Symposium on Pulmonary Hypertension (reference 6).

Tables

  • TABLE 1

    Causes of elevated systolic pulmonary artery pressure on echocardiography

    Echocardiographic limitationsConstitutional factorsHigh cardiac output statesElevated right ventricular afterload
    Inadequate tricuspid regurgitant jet envelope
    Poor estimation of right atrial pressure
    Doppler gain too high    		Age older than 50
    Obesity
    Decreased blood viscosity
    Small right atrium    		Pregnancy
    Anemia
    Cirrhosis
    Hyperthyroidism
    Arteriovenous fistula
    Beriberi
    Skeletal disorders (osteitis deformans, polyostotic fibrous dysplasia, multiple myeloma)    		Pulmonary hypertension
    Pulmonary embolism
    Unilateral pneumonectomy
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