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Pulmonary hypertension — ABIM Board MCQ

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HardPulmonary/Critical CarePulmonary hypertensionABIM Board

A 42-year-old has progressive exertional dyspnea. Echocardiography suggests pulmonary hypertension; right-heart catheterization shows mean pulmonary artery pressure 32 mm Hg, pulmonary artery wedge pressure 9 mm Hg, and pulmonary vascular resistance 4 Wood units. What is the next best step?

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Correct answer: D — Refer to pulmonary-hypertension center for management planning

Pulmonary hypertension is confirmed by right-heart catheterization, and patients with suspected precapillary pulmonary hypertension need expert classification and treatment planning. A normal wedge pressure argues against pulmonary hypertension caused by left-heart filling pressure elevation.

Reference: ACC Summary: 2022 ESC/ERS Pulmonary Hypertension Guideline: https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/08/30/19/11/2022-ESC-Guidelines-for-Pulmonary-Hypertension-ESC-2022