Lupus-Associated Pulmonary Arterial Hypertension: Variable Course and Importance of Prompt Recognition

Figure 1

Echocardiogram of the patient demonstrating key features of severe pulmonary arterial hypertension. (a) Left parasternal short axis view. (b) Four-chamber apical view. Elevated pulmonary artery systolic pressures lead to a dilated right ventricle and right atrium. Dilation of the right ventricle causes flattening of the interventricular septum and the normally larger left ventricle becomes constricted. The rapid heart rate of 120 bpm also reduces the time for left ventricular filling and coronary artery perfusion. All of this results in hemodynamic compromise with decreased cardiac output, which can result in cardiogenic shock.

(a)

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