Category 2 PH secondary to restrictive physiology. (A) ECG showing diffuse T wave inversion. (B) Chest X-ray with right-sided pleural effusion on presentation. (C) Chest X-ray after pleurocentesis left-sided heart enlargement is apparent. (D) Apical 4-chamber echocardiography view showing thickening of the lateral LV wall (black arrow). (E) CT scan showing fibrotic lung disease with right pleural effusion and left ventricle wall mass (white arrow). (F) Cardiac MRI showing right-sided pleural effusion and LV wall mass secondary to growth from non-Hodgkins lymphoma in thorax (white arrow). (G) Still-frame left ventriculogram showing restriction of filling due to extrinsic compression. (H) Simultaneous right and left heart catheterization showing equalization of diastolic filling pressures at ~28 mmHg. PVR in this study was normal (1.9 Wood Units), indicating that the PH was not due to pulmonary vascular disease.
Additional keywords: restrictive physiology,electrocardiogram,echocardiography,x-ray,group 2