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Group 2 Pulmonary Hypertension — RACP Adult Medicine MCQ

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ModerateCardiologyGroup 2 Pulmonary HypertensionRACP Adult Medicine

A 60-year-old woman presents with progressive dyspnoea. Echo shows elevated PASP of 55 mmHg. She has severe mitral regurgitation with left atrial dilatation and LVEF 35%. What is the most likely diagnosis?

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Correct answer: C — Left heart failure

Elevated PASP in the setting of severe mitral regurgitation, LA dilatation, and reduced LVEF indicates pulmonary hypertension due to left heart disease (Group 2 PH). This is the commonest cause of PH. Treatment is directed at the underlying left heart disease. PAH-specific therapies are generally not indicated and may be harmful.

Reference: ESC/ERS – 2022 – PH Guidelines; NHFA/CSANZ 2023 HF