The radiographic appearances in primary and in thromboembolic pulmonary hypertension

Abstract

The appearances in 46 cases of primary or thrombo-embolic hypertension are described, and the cases grouped by the six patterns of abnormality seen in the chest radiograph. In 13 cases it was clear that thromboembolism was the cause of the hypertension; in 10 that it was of the primary or idiopathic variety. From these two groups the characteristic radiographic features for each group were established. Primary pulmonary hypertension was often associated with enlargement of the main and hilar pulmonary arteries without evidence of pulmonary infarction. Clinical or radiological evidence of infarcts or occlusion of some of the larger pulmonary arteries was taken as evidence that the hypertension was due to emboli; dilatation of the main pulmonary artery was uncommon. Applying these criteria to a group of patients in whom the clinical details were insufficient to establish the cause, it seemed that this group consisted predominantly of patients with primary pulmonary hypertension.