Adult Echocardiography Practice Exam

Which of the following is NOT demonstrated in a 2D echo of pulmonary hypertension?

1. paradoxical septal motion

2. enlarged right atrium

3. enlarged pulmonary artery

4. enlarged left ventricle

The correct answer is: enlarged left ventricle

In the context of pulmonary hypertension, the hemodynamic changes typically lead to specific structural adaptations in the heart, particularly affecting the right side. In this scenario, the left ventricle generally does not show signs of enlargement due to pulmonary hypertension. Most commonly, pulmonary hypertension causes increased pressure in the right ventricle, leading to right ventricular hypertrophy and dilation. As the right ventricle works harder to overcome the elevated pressures in the pulmonary artery, the right atrium may also enlarge due to increased pressure and volume loading from the right ventricle. Paradoxical septal motion can be observed in this condition as the interventricular septum may be displaced due to the pressure overload on the right ventricle. Additionally, the pulmonary artery may become enlarged as it accommodates elevated pressures. Therefore, while changes in the right heart structures and the pulmonary artery are indicative of pulmonary hypertension, an enlarged left ventricle is typically not a characteristic finding associated with this condition. The left ventricle may remain normal in size or even become small over time due to decreased preload resulting from compromised pulmonary circulation.