You have been contacted by the infectious diseases team about a man with HIV who has become progressively more breathless over a series of months. He has had a CT pulmonary angiogram which has excluded clots. You discuss the scan with the radiologist.
What else would you like to know about the CT?A) The size of the right ventricle—if it is normal, this excludes pulmonary hypertension as a cause for his symptoms
CT can provide important information in addition to the presence or absence of pulmonary emboli. An enlarged right ventricle (though it can be normally sized), right atrium, and pulmonary arteries are all features of PH. Contrast reflux into the inferior vena cava implies tricuspid regurgitation and increased right atrial pressure. The latter is also indicated when the right atrium is dilated. The position of the interventricular septum and the interatrial septum reflects the balance of pressures between the ventricles and atria, respectively.