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Pulmonary Arterial Hypertension — EECC MCQ

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ModeratePulmonary Vascular DiseasePulmonary Arterial HypertensionEECC

A 45-year-old woman with progressive exertional dyspnoea is found to have a mean pulmonary arterial pressure of 38 mmHg, PAWP of 10 mmHg, and PVR of 5 Wood units on right heart catheterisation. Per the 2022 ESC PH Guidelines, what defines pre-capillary pulmonary hypertension haemodynamically?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — mPAP above 20 mmHg and PAWP 15 mmHg or below and PVR above 2 WU

Explanation lettering: D = shown as A · E = shown as B · B = shown as C · C = shown as D · A = shown as E

The 2022 ESC PH Guidelines lowered the haemodynamic definition of PH to mPAP above 20 mmHg (from the previous 25 mmHg). Pre-capillary PH is defined as mPAP above 20 mmHg, PAWP 15 mmHg or below, AND PVR above 2 WU. This patient meets all criteria. The previous 25 mmHg threshold (B, C) is outdated. The PVR threshold is above 2 WU not 3 WU (D).

Reference: ESC (2022): Guidelines on Pulmonary Hypertension