Pulmonary hypertension in left heart disease

Figures

• 

  Figure 1. Hemodynamic definition of pulmonary hypertension TPG = mPAP – mPCWP, DPG = dPAP – mPCWP, DPG – diastolic pulmonary gradient, dPAP – diastolic pulmonary artery pressure, TPG – transpulmonary gradient, mPAP – mean pulmonary arterial pressure, mPCWP – mean pulmonary capillary wedge pressure, PH – pulmonary hypertension, PVR – pulmonary vascular resistance, WU – Wood units.

• 

  Figure 2. Pathophysiology of pulmonary hypertension and right heart failure in left heart disease

• 

  Figure 3. Echocardiography of patient in Fig. 3 of rheumatic heart disease with severe mitral stenosis in normal sinus rhythm showing: A – thickened mitral leaflets with diastolic doming of anterior mitral leaflet with marked left atrial dilatation, B – mitral valve in short-axis in diastole showing fused medial and lateral commissures with area of 0.78 cm2 by planimetry, C – measurement of mean transmitral gradient of 11 mm Hg, D – dilated left atrium, right atrium and right ventricle, E – CW Doppler of TR jet showing peak velocity of 5.1 m/s with calculated RVSP of 104 mm Hg plus right atrial pressure, F – end-diastolic velocity of pulmonary regurgitation signal of 3 m/s with calculated pulmonary artery end diastolic pressure of 36 mm Hg plus right atrial pressure