Pulmonary hypertension

Question 1

What is the definition of pulmonary hypertension

Answer 1

sustained elevation in mean pulmonary arterial pressure of >25 mmHg at rest.

Question 2

Describe the 5 WHO classifications of pulmonary hypertension

Answer 2

Group 1: Pulmonary arterial hypertension (PAH)

Group 2: Pulmonary HT with left heart disease

Group 3: Pulmonary HT secondary to lung disease/hypoxia

Group 4: Pulmonary HT due to thromboembolic disease

Group 5: Miscellaneous conditions

Question 3

Give examples of conditions which are categorised as Group 1 Pulmonary Hypertension

Answer 3

• idiopathic
• familial
• collagen vascular disease
• congenital heart disease with systemic to pulmonary shunt
• HIV
• drugs and toxins
• sickle cell
• persistent pulmonary hypertension of the newborn

Question 4

Group 2 Pulmonary Hypertension conditions

Answer 4

left-sided atrial, ventricular or valvular disease

e.g. LVSD
mitral stenosis/regurgitation

Question 5

Group 5 Pulmonary Hypertension

Answer 5

lymphangiomatosis
e.g. secondary to carcinomatosis or sarcoidosis

Question 6

Group 3 Pulmonary Hypertension

Answer 6

• COPD
• interstitial lung disease
• sleep apnoea
• high altitude