Cardiology>>>>>Pulmonary Hypertension And Pericardium
Question 1#

A GP contacts you about a young woman in whom a formal diagnosis of pulmonary hypertension has been made. He has not yet received her discharge summary but tells you that she has had a ‘range’ of tests.

Which one of the following would have to have been true in order for the diagnosis to be made?

a. An echocardiogram demonstrated a dilated right heart
b. During an exercise echocardiogram, the estimated RV systolic pressure (derived from the jet of tricuspid regurgitation) was >30 mmHg at peak exercise
c. A CT pulmonary angiogram demonstrated bilateral pulmonary emboli
d. Mean pulmonary artery pressure at rest was ≥25 mmHg on a right heart catheterization
e. During right heart catheterization, the pulmonary wedge pressure was normal

Correct Answer is D


Pulmonary hypertension (PH) is defined as mPAP ≥25 mmHg at rest using invasive measurements made during right heart catheterization. Values during exercise are currently excluded from this definition. In PH, a normal wedge pressure suggests that the cause is not left heart disease. A normal-sized right heart does not exclude PH. Conversely, the presence of pulmonary emboli does not mean that the pulmonary artery pressure will definitely be elevated.