Pulmonary hypertension

image of Pulmonary hypertension
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Pulmonary hypertension (PH) is defined by a systolic pulmonary artery pressure exceeding 32 (or up to 45) mmHg, or a diastolic pressure that exceeds 20 mmHg. The most recent clinical classification scheme for PH in human medicine utilizes pathophysiological characteristics and response to therapy. This classification replaces the previous designation of primary versus secondary PH. Application of the new classification to two retrospective studies in dogs reveals that the most common is PH with left heart disease, while the second most common is PH associated with lung diseases and/or hypoxaemia. Primary (idiopathic) pulmonary arterial hypertension has been reported in dogs but is the least likely. PH as a complication of cardiopulmonary disease seems to be reported more commonly in dogs than in cats. Physiology; History and physical examination; Diagnosis; Treatment; and Prognosis are all addressed in this chapter.

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Image of 28.2
28.2 Radiographs of a 10-year-old Boston Terrier with pulmonary hypertension due to chronic tracheobronchial disease. The lateral radiograph demonstrates increased sternal contact due to right ventricular enlargement. The dorsoventral radiograph reveals rounding of the right heart and an enlarged main pulmonary artery. The pulmonary infiltrative pattern obscures visualization of the pulmonary arteries.
Image of 28.3
28.3 Doppler echocardiography reveals a regurgitant velocity across the tricuspid valve of 4.2 m/s, which correlates with a right ventricular to right atrial pressure gradient of 71 mmHg.
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