BY

DR LAILA

NORMAL
Pulmonary vascular circuit has a very low resistance Carries a volume of 70ml of blood.

NORMAL PULMONARY VASCULATURE

Normally Increased blood flow in lung bases
as compared to the apices d/t gravity

Minimal blood flow to apices Inadequate LA pressure Vessel diameter in upper intercostal spaces is not more than 3mm Main pulmonary artery diameter is 16mm in males and 15mm in females.

Pulmonary hypertension
An increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting n eventually heart failure

PAH
Sustained elevation of mean pulmonary arterial pressure to greater than 25 mmHg at rest or more than 30 mmHg during exercise, with normal pulmonary capillary wedge pressure and left ventricular end-diastolic pressure (<15 mm Hg)

WHO Classification of pulmonary hypertension

Group 1. Pulmonary artery hypertension (PAH) Idiopathic Familial Group 2. Pulmonary hypertension with left heart disease Group 3. Pulmonary hypertension associated with lung disease and/or hypoxaemia Group 4. Pulmonary hypertension due to chronic thrombotic and/or embolic disease Group 5. Miscellaneous (sarcoidosis, histiocytosis X, lymphangiomyomatosis, compression of pulmonary vessels)

PAH

CXR
Hilar pulmonary arterial dilation. Loss of peripheral blood vessel markings OR Peripheral pruning

Enlarged right atrium and right ventricle in advanced diseases

PULMONARY INTERSTITIAL EDEMA

KERLEY B LINES

PERIBRONCHIAL CUFFING

FISSURE EFFUSION

CEPHALIZATION

CEPHALIZATION

PULMONARY ALVEOLAR EDEMA

PULMONARY ALVEOLAR EDEMA

PULMONARY ALVEOLAR EDEMA

PULMONARY HAEMOSIDEROSIS

Longstanding pulmonary venous HTN leads to pulmonary hemosiderosis (punctate calcific) ossific nodules (< 1cm)

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