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Heath-Edwards grading system

Tuesday 26 August 2008

Potenially Reversable

Heath-Edwards grade 1

- hypertrophy of the media of muscular pulmonary arteries
- extension of muscle into the wall of pulmonary arterioles

Heath-Edwards grade 2

- hypertrophy of the media of muscular pulmonary arteries
- proliferation of intimal cells in arterioles and small muscular arteries.

Heath-Edwards grade 3

- hypertrophy of the media of muscular pulmonary arteries
- subendothelial fibrosis.
- Eventually, concentric masses of fibrous tissue and reduplicated internal elastic lamina occlude the vascular lumen of arterioles and small muscular arteries.
- Large elastic arteries show atherosclerosis.

Usually Irreversible

Heath-Edwards grade 4

- Muscle hypertrophy is less apparent;
- progressive dilatation of small arteries, especially those near vessels with intimal fibrous occlusion.
- Plexiform lesions occur.

Heath-Edwards grade 5

- Plexiform and angiomatoid lesions plus intra-alveolar hemosiderin-filled macrophages.

Heath-Edwards grade 6

- Necrotizing arteritis with thrombosis.
- Fibrinoid necrosis of the arterial wall wih a transmural infiltrate of polymorphonuclear leukocytes and eosinophils.

See also

- pulmonary hypertension

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