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Pulmonary hypertension due to left heart disease — SCE Respiratory MCQ

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EasyPulmonary Vascular DiseasePulmonary hypertension due to left heart diseaseSCE Respiratory

A 70-year-old man with severe mitral regurgitation and left atrial enlargement has dyspnoea. Echocardiography estimates high pulmonary pressures; right-heart catheterisation shows mPAP 35 mmHg, PAWP 24 mmHg and PVR 2 Wood units. What is the most likely underlying cause?

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Correct answer: B — Pulmonary hypertension due to left heart disease

Raised mean pulmonary artery pressure with elevated wedge pressure and normal PVR is post-capillary pulmonary hypertension due to left heart disease. Idiopathic PAH is pre-capillary with normal wedge pressure. CTEPH and sarcoidosis-related pulmonary hypertension require different supporting features and usually do not produce this haemodynamic profile.

Reference: ESC/ERS Pulmonary Hypertension Guideline 2022