Pulmonary venous hypertension is currently classified as post-capillary PH based on PCWP, and pulmonary vascular resistance. Radiologically it is categorised into 3 grades.
A normal X ray and grade 1 Pulmonary venous hypertension (Image source Radiopedia ) (Note : Once Pulmonary arterial HT sets in , (either pre or combined pre & post capillary PH) these radiological signs do not reflect the true hemodynamics as pulmonary arterial HT tends to mask both clinical and radiological signs of pulmonary venous HT.
Further questions
Does Pulmonary arteries, veins , travel in the same plane?
No. Pulmonary arteries accompany the bronchial tree mostly .Broncho vascular bundle do not allow veins in side. Instead, veins travel along with lymphatics in the inter- segmental, lobular planes.This anatomical difference has important clinical implications(Link)
Reference
- West JB, Dollery CT, Naimark A. Distribution of blood flow in isolated lung; relation to vascular and alveolar pressures. Journal of Applied Physiology. 1964;19(4):713-724. This is the original description of the zone 1/2/3 model.
- Milne ENC, Pistolesi M, Miniati M, Giuntini C. The radiologic distinction of cardiogenic and noncardiogenic edema. American Journal of Roentgenology. 1985;144(5):879-894.
