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Group 2 pulmonary hypertension — SCE Respiratory MCQ

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HardPulmonary Vascular DiseaseGroup 2 pulmonary hypertensionSCE Respiratory

A 79-year-old man has exertional dyspnoea, ankle swelling and echocardiographic pulmonary hypertension. He has atrial fibrillation, left atrial enlargement and moderate mitral regurgitation. HRCT shows no significant parenchymal lung disease. What is the most likely underlying cause?

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

Left atrial enlargement, mitral regurgitation and atrial fibrillation point to post-capillary pulmonary hypertension from left heart disease. Idiopathic PAH is less likely with clear left-sided structural disease. CTEPH requires thromboembolic evidence and hypersensitivity pneumonitis would usually show ILD features.

Reference: ESC/ERS Pulmonary Hypertension Guideline 2022