Pulmonary hypertension is defined as a mean pulmonary artery pressure that is more than 20 mmHg. Pulmonary hypertension classification has been updated according to the 6th world symposium on pulmonary hypertension 2018. Echocardiography is the key imaging modality in the diagnosis and assessment of pulmonary hypertension.
Pulmonary hypertension can affect the right ventricle leading to dilatation and ultimately right heart failure. Echocardiography gives information on cardiac structure and function. Pulmonary hypertension can result in hypertrophy of the right ventricle (RV) as well as dilatation of RV and right atrium. The use of doppler echocardiography allows estimation of the pulmonary artery pressure to screen, detect and assess the severity of pulmonary hypertension. Hence echocardiography is the most useful screening tool for the detection of pulmonary hypertension.
Echocardiography can also assess possible causes of pulmonary hypertension i.e. due to left heart disease, valve disease or congenital heart disease. In patients with pulmonary hypertension, echo gives useful information of the effects of pulmonary hypertension on the right heart. Assessment of RV function parameters (e.g TAPSE, Tei index) gives prognostic information. The presence of impaired RV function is an indicator of poorer outcomes and serial echo re assessment after therapy can give useful prognostic information.