Pulmopedia

Hypertension - Diagnosis and Management Summary
Group 1: Pulmonary arterial hypertension - Idiopathic, Drug/toxin, CTD, etc
Group 2: L heart disease - Post-capillary (PCWP > 15)
Group 3: Lung disease/hypoxia
Group 4: CTEPH - Chronic thromboembolic (occurs after ~4% of PEs)
Group 5: Miscellaneous
Diagnostic Workup:
• Labs: HIV, ANA, RF/CCP, ANCA, Scl-70, Ro/La, BNP, LFTs
• EKG: R-axis deviation, R/S >1 (V1), RBBB, ↑ P wave (II)
• CXR: ↑PA, ↑R heart border, ↓retrosternal space (↑RV), vascular pruning
• CT: ↑PA, PA:Ao > 1, RV:LV >1, septal flattening, segmental artery:bronchus >1
• PFTs: isolated ↓DLCO(PAH), TLC