SAQ 365 – Respiratory – pulmonary hypertension on CTPA

Review Completed

Marked out of 12.00

A 72-year-old man is sent to ED by his GP after an outpatient CTPA report states: no pulmonary embolus; markedly dilated pulmonary arteries, concerning for pulmonary hypertension and requiring clinical correlation.

The relevant CTPA image is shown below.

Axial CTPA image showing enlarged pulmonary arteries. — CTPA image

List two (2) symptoms that may suggest pulmonary hypertension in this patient.

(Marked out of 2.0)

/ 2

Name two (2) further ED investigations that may identify evidence of pulmonary hypertension.

(Marked out of 2.0)

/ 2

Complete the table with two examples for each pulmonary hypertension classification group, except group 4 which is already supplied.

(Marked out of 8.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Classification group</th> <th>Example 1</th> <th>Example 2</th> </tr> </thead> <tbody> <tr> <td>1. Pulmonary arterial hypertension</td> <td></td> <td></td> </tr> <tr> <td>2. Pulmonary venous hypertension</td> <td></td> <td></td> </tr> <tr> <td>3. Chronic hypoxaemia</td> <td></td> <td></td> </tr> <tr> <td>4. Chronic thromboembolic disease: pulmonary embolism</td> <td></td> <td></td> </tr> <tr> <td>5. Miscellaneous</td> <td></td> <td></td> </tr> </tbody> </table> <p>

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Total Score: 0 / 12

Percentage: 0%

Classification group	Examples
Group 1: pulmonary arterial hypertension	Idiopathic/primary pulmonary arterial hypertension; drug-related disease such as cocaine or amphetamine use.
Group 2: pulmonary venous hypertension	Systolic dysfunction; diastolic dysfunction; valvular disease such as mitral stenosis or regurgitation.
Group 3: chronic hypoxaemia	COPD; interstitial lung disease; sleep-disordered breathing; alveolar hypoventilation; chronic high-altitude exposure.
Group 4: chronic thromboembolic disease	Pulmonary embolism.
Group 5: miscellaneous or multifactorial	Myeloproliferative disorders; sarcoidosis or vasculitis; metabolic disease such as glycogen storage disease; tumour obstruction, fibrosing mediastinitis, or chronic renal failure on dialysis.

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