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The transthoracic echocardiography images from 3 patients (below) demonstrate cardiac findings across the spectrum of pulmonary hypertension. Each of the 3 patients is a woman with dyspnea, exercise intolerance, and increased pulmonary artery systolic pressure on echocardiography. The similarity in the presentation (in symptoms, functional class, and some aspects of the physical examination) demonstrates the challenge of accurately diagnosing the cause of pulmonary hypertension in these types of complex patients. Echocardiographic and invasive hemodynamic features, coupled with the rest of the clinical data, assisted in establishing the final diagnosis in each patient.
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