PAH, Severe pulmonary hypertension indicates there is high resistence to the blood pumped from the right ventricle to the lungs. The cause can be blood clots (thrombosis) in the pulmonary vessel, and/or lung malady such as emboli (clots). etc.
Dilated RV (right ventricle) and dilated RA (right atrium). The underly cause can be the severe PAH.
Diastolic dysfunction indicates there is an issue of the filling phase of heartbeat cycle. Usually it applies to the left ventricle, and enlarged and rigid heart chamber walls impedes the filling phase by being unable to relax (rigid) the heart wall to expand and adequately fill also thicker walls reduces the space of the chamber.
Trival MR (mitral valve) is medically insignificant, Severe tricuspid valve (TR) is problematic. Aortic valve sclerosed indicates there is some calcification of the valve opening and possibly the leaflets...can cause abnormal pressure in the left ventricle if the calcification narrows (stenosis) of the valve opening and/or regurgitation if the leaflets don't close effectively to cover the valve opening.
Right ventricle systole pressure (RVSP) is the systole pressure of the right ventricle and normal is 25-30mmHg. That accounts for the severe PAH.
Hope this helps, if not feel free to followup. Thanks for sharing.