skip to main content

Pulmonary arterial hypertension in systemic sclerosis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardCardiologyPulmonary arterial hypertension in systemic sclerosisRACP Adult Medicine

A 46-year-old woman with limited cutaneous systemic sclerosis develops progressive exertional dyspnoea. Spirometry is near normal but DLCO is 42% predicted. Echocardiography estimates elevated pulmonary artery systolic pressure and shows right ventricular dilatation. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Right heart catheterisation

Right heart catheterisation is required to confirm pulmonary arterial hypertension and define haemodynamics before targeted therapy. Echo and DLCO are useful screening clues but are not definitive. Repeat spirometry, coronary angiography, ABG alone and skin biopsy do not establish the pulmonary vascular diagnosis.

Reference: TSANZ pulmonary hypertension guidance; AMH