A woman with systemic lupus erythematosus has progressive exertional dyspnoea, reduced DLCO and estimated pulmonary artery systolic pressure 55 mmHg.

Question

A woman with systemic lupus erythematosus has progressive exertional dyspnoea, reduced DLCO and estimated pulmonary artery systolic pressure 55 mmHg. CTPA excludes chronic thromboembolism. What test is required before pulmonary arterial hypertension-specific treatment?

Accepted Answer

Right-heart catheterisation to confirm haemodynamics and classify pulmonary hypertension

Answer

Repeat echocardiography alone until the estimated pressure exceeds 70 mmHg

Answer

Use bronchoscopy to measure pulmonary vascular resistance

Answer

Start a pulmonary vasodilator empirically because echocardiography establishes the diagnosis

Answer

Use a normal troponin to exclude clinically important pulmonary hypertension

SLE PAH — RACP Adult Medicine MCQ

A woman with systemic lupus erythematosus has progressive exertional dyspnoea, reduced DLCO and estimated pulmonary artery systolic pressure 55 mmHg. CTPA excludes chronic thromboembolism. What test is required before pulmonary arterial hypertension-specific treatment?