Service de cardiologie, Service de médecine interne, Hôpital Robert-Debré, Reims
The incidence of pulmonary hypertension is rare after a first pulmonary thromboembolism. Diagnosis is better undertaken by echocardiographic monitoring during the first weeks after the initial occurrence. The analysis is based on echographic right ventricular dilatation and function, and first of all by the measurement of the maximum velocity of the systolic tricuspid pic flow using continuous wave Doppler. Analysis of the chronic nature of pulmonary hypertension may be assessed by using adjunctive pulse wave Doppler measurement of the systolic pic duration of the pulmonary outflow. Predictors of sustained thromboembolic pulmonary hypertension are the level of right ventricular overpressure during the first month and systemic variables such as the patient’s age. The prognostic role of right ventricular dysfunction is still debated in the setting of thromboembolic disease, in contrast to primary pulmonary hypertension.