患者自我描述：女，35岁，已婚，因反复活动后胸闷气喘2个月加重（前7-8年尤其是在爬楼梯时也有这种情况，当时以为是低血糖就没有在意，但这次更加严重，就连走平路都有症状。）于2011-01-20入院，入院检查：
体温：36.5℃ 脉搏:78次/分 呼吸:20次/分 血压:120/88mmHg. 胸骨无压痛，呼吸运动正常，肋间隙无增宽、变窄，无胸膜摩檫感及皮下捻发感，叩诊清音，呼吸音清，未闻及干、湿性罗音。心前区无隆起，心尖搏动位于第五肋间隙、左锁骨中线内0.5cm处，心浊音界无扩大，心率78次/分，律齐，P2亢进，各瓣膜区未闻及明显杂音。
心电图：右心室肥大(电轴C+153°,avR呈qR型，R＞0.5mv,V1呈R型，R＞1.0mv,Sv1+R＞1.2mv)。
肺动脉CTA示：肺动脉未见明显血栓征象；主肺动脉增宽，提示肺动脉高压形成（肺动脉充盈良好，主肺动脉无扩张，内径约30.6mm,同水平升主动脉内径20.0mm, 降主动脉内径17.3mm,段以上肺动脉内未见明显充盈缺损影）。
心脏彩超：1、右心增大，三尖瓣反流+++ 2、肺动脉增宽，肺动脉增高（二尖瓣口血流：E/A呈单峰；三尖瓣口收缩期见反流信号+++，峰速5.02m/s,压差102mmHg，估计肺动脉压112 mmHg）。
心脏正侧位片：1、心影改变，建议随诊复查或进一步彩超检查；2、双肺未见明显异常。
SPECT：静息心肌断层显像示：1、左心室腔小，室壁放射性分布呈小片状稀疏减低，符合心肌病变表现； 2、右心室明显扩大，室壁肥厚。
病历与检查结果：
1、有明显胸闷、气喘等呼吸困难症状，活动后加重，且反复发作。
2、右心室肥厚和扩大：心脏彩超、心肌断层显像与心电图均显示：右心增大、室壁肥厚，右心室明显扩大等改变；
3、肺动脉内径增宽：肺动脉CTA示：肺动脉增宽，提示肺动脉高压形成；心脏彩超示 肺动脉增宽。
4、三尖瓣反流：心脏彩超示 三尖瓣反流+++
5、肺动脉压增高：心脏彩超检查 估计肺动脉压112 mmHg。
根据病人以上症状与检查结果，符合肺动脉高压改变，如能除外继发性肺动脉高压，如风心病、先心病等疾病，可诊断为原发性肺动脉高压。
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