Snippet 24: The Radiologist’s Role in Pulmonary Hypertension

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CT Chest ReviewBhavin Jankharia

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The causes of PH are typically grouped into the following

Group 1 - PAH (idiopathic, etc)
Group 2 - Left heart disease - failure, valvular heart disease, shunts
Group 3 - Diffuse lung disease
Group 4 - CTEPD/CTEPH
Group 5 - Misc including fibrosing mediastinitis

As radiologists, we encounter patients with pulmonary hypertension (PH) on a daily basis. Most of them have already been diagnosed with PH on echo and the commonest causes are Gr 2 and Gr 3 etiologies. We don't typically have any role to play in the diagnosis of PH or in the etiology in such situations.

But there are times when the etiology is indeterminate and it is for us to find the cause.

There are also many situations where we need to mention the MPA diameter as part of our report to draw attention to the fact that there is likely PH (especially when the MPA diameter is > 32 mm).

The short video discusses all of these issues and specially the conditions where we as radiologists make a difference in helping with the diagnosis of specific causes of PH.