Elevated pulmonary pressure noted on echocardiogram: A simplified approach to next steps

Manreet K. Kanwar, Ryan J. Tedford, Thenappan Thenappan, Teresa De Marco, Myung Park, Vallerie McLaughlin

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


An elevated right ventricular/pulmonary artery systolic pressure suggestive of pulmonary hypertension (PH) is a common finding noted on echocardiography and is considered a marker for poor clinical outcomes, regardless of the cause. Even mild elevation of pulmonary pressure can be considered a modifiable risk factor, informing the trajectory of patients’ clinical outcome. Although guidelines have been published detailing diagnostic and management algorithms, this echocardio-graphic finding is often underappreciated or not acted upon. Hence, patients with PH are often diagnosed in clinical practice when hemodynamic abnormalities are already moderate or severe. This results in delayed initiation of potentially effective therapies, referral to PH centers, and greater patient morbidity and mortality. This mini-review presents a succinct, simplified case-based approach to the “next steps” in the work-up of PH, once elevated pulmonary pressures have been noted on an echocardiogram. Our goal is for clinicians to develop a good overview of diagnostic approach to PH and recognition of high-risk features that may require early referral.

Original languageEnglish (US)
Article numbere017684
JournalJournal of the American Heart Association
Issue number7
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.


  • Echocardiogram
  • PA pressures
  • Pulmonary hypertension


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