The elevated Qp/QS indicates
shuntCyanotic heart disease
Transjugular intrahepatic portosystemic shunt (tips) from left side to right side of the heart that can in the long term lead to elevated pulmonary pressures. The elevated pulmonary pressures can cause damage to the lung which ultimately may lead to dilation of pulmonary arteries. Of course, all of this has to fit some type of a clinical picture. In a 59 year old male with no symptoms those results should be confirmed either with an echocardiogram or a cardiac MRI to assess for presence of a shunt. It is possible that those results are false positives, however, given the ramifications of elevated pulmonary pressures due to shunting and the fact that all this can be easily repaired, one should have this worked up further. Atiral septal defect could cause this and should be ruled out.