skip to main content

PH Classification - Group 1 IPAH — EECC MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePulmonary Vascular DiseasePH Classification - Group 1 IPAHEECC

A 50-year-old woman undergoes right heart catheterisation for suspected PH. Results show mPAP 28 mmHg, PAWP 10 mmHg, PVR 4.5 WU, cardiac output 4.0 L/min. Connective tissue disease screen and HIV test are negative. V/Q scan shows no perfusion defects. Pulmonary function tests are normal. What group of PH is this?

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

Reveal the answer and explanation

Correct answer: B — Group 1 PAH (idiopathic pulmonary arterial hypertension) after exclusion of other causes

This patient has pre-capillary PH (mPAP >20, PAWP ≤15, PVR >2 WU) with no evidence of left heart disease (normal PAWP), lung disease (normal PFTs), or CTEPH (normal V/Q scan). After excluding secondary causes (CTD, HIV, drugs, portal hypertension, CHD), this is classified as idiopathic PAH (Group 1). The 2022 ESC/ERS PH Guidelines classify PH into 5 groups: (1) PAH, (2) PH due to left heart disease, (3) PH due to lung disease/hypoxia, (4) CTEPH, (5) PH with unclear/multifactorial mechanisms. Treatment for Group 1 PAH follows the ESC risk stratification algorithm with initial combination oral therapy and potential escalation to parenteral prostacyclins.

Reference: ESC/ERS (2022): Guidelines for Pulmonary Hypertension