Purpose To evaluate the value of the echocardiographic exam for the diagnosis of the persistent pulmonary hypertension (PPHN) in the newborn infant.

Methods Patients, 41 newborns (aged 0–8 days) with PPHN induced by severe perinatal hypoxia, meconium aspiration syndrome, hyaline membrane disease, hypotermia, neonatal sepsis, infant of diabetic mothers, congenital cardiac malformations. Investigations of patients: clinical exam PaO₂, ECG, chest X ray, Doppler echocardiography (ECHO). ECHO was repeated after 5–7 days in all patients.

Results Physical exam, cyanosis in the first 12 hours, tachypnea and/or a severe respiratory distress, systolic murmur on the left border of sternum. ECG: diastolic dysfunction of left ventricular (LV). Chest X ray: cardiomegaly (all cases). PaO₂: low values-all patients. ECHO aspects: enlargement of the right chambers; severe tricuspid regurgitation with the peak velocity 3–4 m/sec; mitral regurgitation (12/41 of cases), left-to-right shunt across foramen ovale and/or ductus arteriosus (30/41 of cases), enlargement of the pulmonary artery and severe pulmonary regurgitation, septal hypertrophy (11/41 of cases); impaired LV relaxation with normal systolic function; congenital heart diseases (7). Repeated ECHO revealed in most of the cases diminished or no right-to left shunt across ductus arteriosus or foramen ovalae correlate with clinical improvement and disappearance of cyanosis.

Conclusions Echocardiographic exam, beside clinical exam and history of the disease, is un important element for the diagnosis and follow up of evolution by the specific treatment applied for PPHN in the newborn with cyanosis and this investigation must be performed early after birth.