A Diagnosis at Hand: Pulmonary Arterial Hypertension

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Presentation transcript:

A Diagnosis at Hand: Pulmonary Arterial Hypertension Kavita Khaira, MD, Roblee Allen, MD, Ezra A. Amsterdam, MD The American Journal of Medicine Volume 129, Issue 8, Pages 812-815 (August 2016) DOI: 10.1016/j.amjmed.2016.04.005 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Sclerodactyly of the fingers was evident when viewing the dorsal aspect of the patient's hand. The American Journal of Medicine 2016 129, 812-815DOI: (10.1016/j.amjmed.2016.04.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 The patient had telangiectasias on her cheeks and forehead. The American Journal of Medicine 2016 129, 812-815DOI: (10.1016/j.amjmed.2016.04.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 3 An electrocardiogram showed normal sinus rhythm, first-degree atrioventricular block, and left posterior fascicular block. Right ventricular pressure overload with pulmonary hypertension was demonstrated by right axis deviation, incomplete right bundle branch block, right ventricular hypertrophy with ST depression, and T-wave inversion in the precordial and inferior leads. The American Journal of Medicine 2016 129, 812-815DOI: (10.1016/j.amjmed.2016.04.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 4 Transthoracic echocardiogram (TTE) images were obtained when the patient was admitted. (A) An apical 4-chamber view disclosed marked right atrial (RA) and right ventricular (RV) enlargement with right ventricular hypertrophy (arrow). (B) A short-axis TTE view demonstrated right ventricular pressure overload with systolic septal flattening or the “D sign” (arrow). LA = left atrial; LV = left ventricular. The American Journal of Medicine 2016 129, 812-815DOI: (10.1016/j.amjmed.2016.04.005) Copyright © 2016 Elsevier Inc. Terms and Conditions