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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