1. A Diagnosis at Hand: Pulmonary Arterial Hypertension
Kavita Khaira, MD, Roblee Allen, MD, Ezra A. Amsterdam, MD 
The American Journal of Medicine 
Volume 129, Issue 8, Pages (August 2016)
DOI: /j.amjmed
Copyright © 2016 Elsevier Inc. Terms and Conditions

2. Figure 1
Sclerodactyly of the fingers was evident when viewing the dorsal aspect of the patient's hand.
The American Journal of Medicine  , DOI: ( /j.amjmed )
Copyright © 2016 Elsevier Inc. Terms and Conditions

3. Figure 2 The patient had telangiectasias on her cheeks and forehead.
The American Journal of Medicine  , DOI: ( /j.amjmed )
Copyright © 2016 Elsevier Inc. Terms and Conditions

4. Figure 3
An electrocardiogram showed normal sinus rhythm, first-degree atrioventricular block, and left posterior fascicular block. Right ventricular pressure overload with pulmonary hypertension was demonstrated by right axis deviation, incomplete right bundle branch block, right ventricular hypertrophy with ST depression, and T-wave inversion in the precordial and inferior leads.
The American Journal of Medicine  , DOI: ( /j.amjmed )
Copyright © 2016 Elsevier Inc. Terms and Conditions

5. Figure 4
Transthoracic echocardiogram (TTE) images were obtained when the patient was admitted. (A) An apical 4-chamber view disclosed marked right atrial (RA) and right ventricular (RV) enlargement with right ventricular hypertrophy (arrow). (B) A short-axis TTE view demonstrated right ventricular pressure overload with systolic septal flattening or the “D sign” (arrow). LA = left atrial; LV = left ventricular.
The American Journal of Medicine  , DOI: ( /j.amjmed )
Copyright © 2016 Elsevier Inc. Terms and Conditions