Pulmonary hypertension is suspected if highest estimated RVSP/sPAP is 40 mmHg or more by TRJ or PDA/VSD gradient, if diastolic PAP at least 20 mmHg or more, Eccentricity index 1.3 or more (flattening of septum) or if PAAT/RVET less than 0.29). Once PH is suspected, once must evaluate whether it is due to high pulmonary vascular resistance, high pulmonary blood flow, increased pulmonary capillary wedge pressure a combination of those.
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