Investigations
- the ECG may show right ventricular hypertrophy and deviation in addition to peaked P waves in lead II.
- chest radiography may show prominent arterial conus and proximal pulmonary arteries. There may be evidence of undervascularization in the peripheral lung fields.
- pulmonary arteriography and lung scanning are not often useful, but may reveal peripheral pruning
- cardiac catheterisation confirms pulmonary hypertension; excludes left heart disease by measuring wedge pressure and excludes right to left shunt by measuring the amount of oxygen content in the right heart.
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