Review articleEchocardiography in pulmonary vascular disease
Section snippets
Measurement of right ventricular volume and function
Measurement of right ventricular volume and function is important in making the diagnosis of pulmonary hypertension, but, because of the complex three-dimensional shape of the right ventricle, accurate measurement of right ventricular size and ejection fraction is difficult. In the apical four-chamber view, enlargement of the right ventricle can be determined qualitatively when its chamber cross-sectional area exceeds that of the left ventricle (Fig. 1). In addition, right ventricular
Typical findings on transthoracic echocardiography
Depending on the size of the thromboembolus, patients with acute pulmonary embolism may have a number of abnormalities on TTE. Rarely, a large thrombus may be directly visualized in a proximal pulmonary artery or in transit in the right-heart chambers (Fig. 5A–C) [13]. The most common echocardiographic findings, however, are caused by acute right-sided pressure overload. With acute massive pulmonary embolism, the right ventricle dilates and becomes markedly hypokinetic. Abnormal motion of the
Echocardiography in chronic right ventricular overload and pulmonary hypertension
The nonspecific nature of symptoms from chronic pulmonary hypertension often impedes the early diagnosis of the condition. For example, Rubin et al [39] reported a mean time from presentation to diagnosis of approximately 2 years in patients with pulmonary hypertension. In general, pulmonary vascular disease should be suspected when symptoms of dyspnea cannot be easily explained. When pulmonary hypertension is suspected from physical examination or screening tests (such as electrocardiography
Summary
Pulmonary vascular disease is an entity of diverse causes and varied morphologic and physiologic derangements. Echocardiography has evolved into a primary clinical tool for the diagnosis and management of pulmonary vascular disease and pulmonary hypertension. Echocardiography can help quantify right-heart function, right atrial and ventricular pressures, left ventricular function, and responses to treatment. The role of echocardiography in this area continues to evolve. Areas of active
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