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CT imaging in pulmonary hypertension

cardiovascular CT Marusa Kotnik Nicholas Screaton pulmonary hypertension

Pulmonary hypertension (PH) is a multifactorial, progressive disease currently defined by elevated mean pulmonary arterial pressure (mPAP) of ≥25mmHg at rest or >30mmHg during exercise. If untreated it can lead to right heart failure and death and is an important cause of mortality and morbidity. However, patients often present with non-specific cardiovascular and respiratory symptoms including dyspnoea, fatigue, chest pain or angina, and syncope.

Causes of PH are many and varied involving different pathophysiological processes. In 2013, the World Health Organization (WHO) classified PH into five groups based on similar aetiology and therapeutic option, with the most recent reclassification in 2018 introducing only minor changes. The most common causes are PH secondary to chronic left heart failure (group 2) and lung disease/hypoxia (group 3).

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