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Medicine

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Respiratory

Question
4 out of 6
 

Precapillary Pulmonary hypertension is caused by all Except (DNB Dec 2011)



A Mitral stenosis

B Pulmonary vasculitis

C Primary pulmonary hypertension

D Thromboembolism

Ans. A

Mitral stenosis

Features

Precapillary

Passive (Post-capillary)

Pathophysiology

Abnormality that leads to elevated

pulmonary artery pressure is located in the pulmonary artery or arterioles.

Abnormalities that lead to elevated pulmonary artery pressure are located beyond the pulmonary arteries.

These are caused by diseases that lead to increased pulmonary venous pressure that in turn produces secondary elevation in pulmonary arterial pressure.

Left Atrial (LA) Pressure (PCWP)

PA-LA Pressure

Gradient

Normal

> 12mm

<12mmHg

Causes

Primary PAH

Disorders of ventilation

CHD with PAH

Pulmonary embolism

Schistosomiasis

Collagen vascular disease

Pulmonary vasculitis

Sickle hemoglobinopathies

Portal hypertension

Left ventricular failure

Mitral valve disease

Obstruction of major pulmonary veins

Congenital pulmonary vein stenosis

Left atrial myxoma

Extra Edge:

1). Pulmonary wedge pressure is not a feature of Precapillary Pulmonary hypertension.

2). In precapillary pulmonary hypertension the abnormality that leads to elevated pulmonary pressure is located in the pulmonary artery or arterioles.

3). The Left atrial pressure or Pulmonary capillary wedge pressure is essentially normal.