Diastolic heart failure may be the most common cause Pulmonary hypertension in the elderly,part 1: Evaluation

摘要

Pulmonary arterial hypertension (PAH) is an increasingly recognized cause of dyspnea in elderly patients. The initial workup typically includes electrocardiography, chest radiography, echocardiography, and pulmonary function tests. If echocardiography shows signs of PAH, the diagnosis should be confirmed by right heart catheterization. Radiographic evidence of long-standing PAH includes enlargement of the central pulmonary arteries with abrupt narrowing of the more distal branches, giving a "pruned-tree" appearance, and right ventricular (RV) enlargement. The classic radiographic signs of RV enlargement include increased transverse diameter of the heart, elevation of the cardiac border on the posteroanterior view, and narrowing or loss of the retrosternal airspace on the lateral projection.