Pulmonary hypertension associated with chronic obstructive pulmonary disease

Pulmonary hypertension associated with chronic obstructive pulmonary disease (PH-COPD) can be a common complication of chronic obstructive pulmonary disease and usually manifests as mild to moderate pulmonary hypertension in those with advanced COPD. Pulmonary arterial pressures in this situation most ranges around 25-35 mmHg ³. A small proportion of COPD patients may present of a severe or "disproportionate" pulmonary arterial pressures with resting pulmonary arterial pressures around > 35-40 mmHg ³. 

Epidemiology

The reported incidence of mild to moderate pulmonary hypertension is as high as 50% of cases with advanced chronic obstructive pulmonary disease ⁵.

Pathology

Pulmonary vascular remodeling in COPD is considered the main cause of increased pulmonary arterial pressures and is thought to be a result of combined effects of hypoxia, inflammation and loss of capillaries in severe emphysema.

Radiographic features

CT 

Imaging may show concurrent presence of features of pulmonary hypertension as well as features of COPD/emphysema although a causative/associative relationship requires careful consideration of clinical features and absence of features than overtly contribute or pulmonary hypertension.