Systemic Hypertension
Definition
Systolic blood pressure above 140 mm Hg and diastolic pressure above 90 mm Hg
Etiology
- The specific etiology can be determined in only a small number of patients—secondary hypertension
- Increased peripheral resistance resulting from vasoconstriction or narrowing of peripheral blood vessels—primary hypertension.
Echocardiography
- Detects left ventricular hypertrophy
- Detects increased left ventricular mass
- Allows serial evaluation of patients diagnosed with hypertension
- Allows careful evaluation of the aorta, which may become dilated or dissected
M-Mode/2-D
- Left ventricular hypertrophy
- Increased left ventricular mass
- Left ventricular dilatation (late in course)
- Left atrial enlargement
- Decreased E-F slope (indicating decreased left ventricular compliance)
- Mitral annular calcification
- Aortic root dilatation/aortic dissection
- Discrete interventricular septal thickening
Doppler
- Aortic regurgitation if the aortic root is dilated
- Abnormal left ventricular diastolic filling pattern
LV Hypertrophy Severity Scales
- Normal : 0.7 to 1. 1 cm
- Mild : 1.2 to 1.4 cm
- Moderate : 1.5 to 1.9 cm
- Severe :>2.0 cm