Clinical, electrocardiographic, and radiological evaluation of pulmonary hypertension in patients with mitral stenosis.

Fifty-one patients with dominant rheumatic mitral stenosis were studied by clinical, electrocardiographic, and radiological criteria for evaluation of pulmonary hypertension. Predicted pulmonary artery pressure from these criteria were then compared with the pulmonary artery pressure measured during cardiac catheterization. In the first 31 patients, the assessment of pulmonary hypertension using combined clinical, electrocardiographic, and radiological methods gave better results than any one single method alone. On the basis of these observations, a composite criterion was arrived at. This new criterion was then prospectively applied to the next 20 consecutive patients with dominant mitral stenosis. In 14 of the 20 patients, the predicted pulmonary artery mean pressures were in the same range as the measured mean pulmonary artery pressures when the new composite criterion was used.