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Systemic sclerosis pulmonary arterial hypertension — SCE Respiratory MCQ

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HardPulmonary Vascular DiseaseSystemic sclerosis pulmonary arterial hypertensionSCE Respiratory

A 43-year-old woman with limited cutaneous systemic sclerosis has worsening exertional dyspnoea. Echo estimates raised pulmonary artery pressure; HRCT shows minimal ILD and NT-proBNP is raised. What is the most appropriate investigation?

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Correct answer: D — Right heart catheterisation

Right heart catheterisation is required to confirm pulmonary arterial hypertension and define haemodynamics before targeted therapy. Empirical vasodilator treatment without confirmation risks missing left-heart or lung-disease causes. Chest radiography and spirometry cannot establish pulmonary vascular pressures accurately.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/