eMedicine Specialties > Pulmonology > Pulmonary Hypertension

Pulmonary Hypertension, Secondary: Multimedia

Author: Nader Kamangar, MD, FACP, FCCP, FAASM,, Associate Professor of Clinical Medicine, Director of Hospitalist/Intensivist Program, Division of Pulmonary, Critical Care and Sleep Medicine, David Geffen School of Medicine at University of California Los Angeles; Associate Director, Combined Pulmonary and Critical Care Fellowship Program, Cedars-Sinai/Olive View-UCLA/West Los Angeles Veterans Affairs Medical Center
Coauthor(s): Shahriar Pirouz, MD, Resident Physician, Department of Internal Medicine, Olive View University of California Los Angeles Medical Center; Sat Sharma, MD, FRCPC, Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St Boniface General Hospital
Contributor Information and Disclosures

Updated: Aug 21, 2009

Multimedia

Gross pathology on a patient who died from severe...
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Media file 1: Gross pathology on a patient who died from severe pulmonary hypertension secondary to persistent patent ductus arteriosus.
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Gross pathology on a patient who died from severe...

Gross pathology on a patient who died from severe pulmonary hypertension secondary to persistent patent ductus arteriosus.

Another view (of picture in Media File 1) of gros...
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Media file 2: Another view (of picture in Media File 1) of gross pathology on a patient who died from severe pulmonary hypertension secondary to persistent patent ductus arteriosus.
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Another view (of picture in Media File 1) of gros...

Another view (of picture in Media File 1) of gross pathology on a patient who died from severe pulmonary hypertension secondary to persistent patent ductus arteriosus.

During a pulmonary arterial thromboendarterectomy...
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Media file 3: During a pulmonary arterial thromboendarterectomy, a bilateral proximal thrombus was carefully dissected and extracted, leading to the resolution of secondary pulmonary artery hypertension.
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During a pulmonary arterial thromboendarterectomy...

During a pulmonary arterial thromboendarterectomy, a bilateral proximal thrombus was carefully dissected and extracted, leading to the resolution of secondary pulmonary artery hypertension.

Chest radiograph of a patient with secondary pulm...
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Media file 4: Chest radiograph of a patient with secondary pulmonary hypertension shows enlarged pulmonary arteries. This patient had an atrial septal defect.
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Chest radiograph of a patient with secondary pulm...

Chest radiograph of a patient with secondary pulmonary hypertension shows enlarged pulmonary arteries. This patient had an atrial septal defect.

A 54-year-old woman with history of scleroderma (...
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Media file 5: A 54-year-old woman with history of scleroderma (CREST variety, ie, calcinosis cutis, Raynaud phenomenon, esophageal motility disorder, sclerodactyly, and telangiectasia) developed dyspnea that worsened upon exertion. Images from a high-resolution CT scan of the lungs showed no parenchymal disease. The patient was found to have severe pulmonary arterial hypertension.
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A 54-year-old woman with history of scleroderma (...

A 54-year-old woman with history of scleroderma (CREST variety, ie, calcinosis cutis, Raynaud phenomenon, esophageal motility disorder, sclerodactyly, and telangiectasia) developed dyspnea that worsened upon exertion. Images from a high-resolution CT scan of the lungs showed no parenchymal disease. The patient was found to have severe pulmonary arterial hypertension.

A 54-year-old woman with history of scleroderma (...
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Media file 6: A 54-year-old woman with history of scleroderma (CREST variety, ie, calcinosis cutis, Raynaud phenomenon, esophageal motility disorder, sclerodactyly, and telangiectasia) developed dyspnea that worsened upon exertion. Spiral CT scan image showed enlarged pulmonary arteries but no evidence of thromboembolism (same patient as in Media File 5).
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A 54-year-old woman with history of scleroderma (...

A 54-year-old woman with history of scleroderma (CREST variety, ie, calcinosis cutis, Raynaud phenomenon, esophageal motility disorder, sclerodactyly, and telangiectasia) developed dyspnea that worsened upon exertion. Spiral CT scan image showed enlarged pulmonary arteries but no evidence of thromboembolism (same patient as in Media File 5).

A ventilation/perfusion scan of bilateral mismatc...
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Media file 7: A ventilation/perfusion scan of bilateral mismatched segmental and subsegmental defects, suggesting chronic thromboembolic hypertension.
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A ventilation/perfusion scan of bilateral mismatc...

A ventilation/perfusion scan of bilateral mismatched segmental and subsegmental defects, suggesting chronic thromboembolic hypertension.

This left pulmonary arterial angiogram shows larg...
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Media file 8: This left pulmonary arterial angiogram shows large central pulmonary arteries and attenuation of peripheral vessels, but thrombosis cannot be identified because it has organized along the vessel walls.
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This left pulmonary arterial angiogram shows larg...

This left pulmonary arterial angiogram shows large central pulmonary arteries and attenuation of peripheral vessels, but thrombosis cannot be identified because it has organized along the vessel walls.

Bilateral angiogram should be performed in patien...
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Media file 9: Bilateral angiogram should be performed in patients suggested to have chronic thromboembolic pulmonary arterial hypertension. This right pulmonary arterial angiogram from the patient in Media File 8 again shows no evidence of a filling defect, therefore excluding acute thrombosis. Angioscopy is a potentially useful procedure in this setting.
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Bilateral angiogram should be performed in patien...

Bilateral angiogram should be performed in patients suggested to have chronic thromboembolic pulmonary arterial hypertension. This right pulmonary arterial angiogram from the patient in Media File 8 again shows no evidence of a filling defect, therefore excluding acute thrombosis. Angioscopy is a potentially useful procedure in this setting.

More on Pulmonary Hypertension, Secondary

Overview: Pulmonary Hypertension, Secondary
Differential Diagnoses & Workup: Pulmonary Hypertension, Secondary
Treatment & Medication: Pulmonary Hypertension, Secondary
Follow-up: Pulmonary Hypertension, Secondary
Multimedia: Pulmonary Hypertension, Secondary
References
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Further Reading

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Contributor Information and Disclosures

Author

Nader Kamangar, MD, FACP, FCCP, FAASM,, Associate Professor of Clinical Medicine, Director of Hospitalist/Intensivist Program, Division of Pulmonary, Critical Care and Sleep Medicine, David Geffen School of Medicine at University of California Los Angeles; Associate Director, Combined Pulmonary and Critical Care Fellowship Program, Cedars-Sinai/Olive View-UCLA/West Los Angeles Veterans Affairs Medical Center
Nader Kamangar, MD, FACP, FCCP, FAASM, is a member of the following medical societies: American Academy of Sleep Medicine, American Association of Bronchology, American College of Chest Physicians, American College of Physicians, American Lung Association, American Medical Association, American Thoracic Society, California Thoracic Society, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Shahriar Pirouz, MD, Resident Physician, Department of Internal Medicine, Olive View University of California Los Angeles Medical Center
Disclosure: Nothing to disclose.

Sat Sharma, MD, FRCPC, Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St Boniface General Hospital
Sat Sharma, MD, FRCPC is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Thoracic Society, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, Society of Critical Care Medicine, and World Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Oleh Wasyl Hnatiuk, MD, Program Director, National Capital Consortium, Pulmonary and Critical Care, Walter Reed Army Medical Center; Associate Professor, Department of Medicine, Uniformed Services University of Health Sciences
Oleh Wasyl Hnatiuk, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

,, Kathy Roarty Placeholder
Disclosure: Nothing to disclose.

CME Editor

Timothy D Rice, MD, Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, Saint Louis University School of Medicine
Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians
Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD, Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center; Professor of Medicine, David Geffen School of Medicine at UCLA
Zab Mosenifar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society
Disclosure: Nothing to disclose.

 
 
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