Pulmonary Hypertension: Guideline Directed Management
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A 27-year-old woman presented with shortness of breath over the past year and a history of antiphospholipid syndrome. Examination revealed edema, elevated jugular venous pressure, murmur, and signs of pulmonary hypertension. Echocardiogram showed severe tricuspid regurgitation, mild pulmonary regurgitation, dilated right atrium and ventricle, and elevated pulmonary artery systolic pressure of 110mmHg. The patient was diagnosed with pulmonary hypertension of unclear etiology and advised to undergo further tests and discharged on treatment for pulmonary arterial hypertension.
Pulmonary Hypertension: Guideline Directed Management
- 1. Journal Club 19-09-2017 Dr. Azim Anwar Brown Unit Dept of Internal Medicine BSMMU
- 2. Shikha Datta, 27 years old, admitted on BSMMU with the complain of Shortness of Breath on exertion, which was progressively increasing day by day over the last 1 year. 1 year back she admitted on BSMMU with bilateral leg swelling and was diagnosed as APS and since then she is been treated with Warfarin and Hydroxychloroquine.
- 3. On Examination • Distressed • Anemic • Bilateral pitting ankle edema • JVP Raised • Loud P2 • Pan Systolic Murmur at left sternal edge with no radiation. • Other examination findings are normal.
- 4. Investigation • Color Doppler Echocardiogram: Severe TR, Mild PR RA, RV dilated, Severe PHTN (PASP 110mmhg) EF 62%
- 5. Diagnosis • Pulmonary hypertension due to- ???  Chronic thromboembolic Disease Congenital Shunt Primary Pulmonary Hypertension
- 13. Investigations
- 21. Treatment
- 43. What We Did ???
- 45. Discharge Treatment • Tab. Ambrisentan 5mg, 1+1+1+1 • Tab. Tadalafil 10mg, 0+0+4
- 46. THANK YOU