A 45-year-old woman with progressive dyspnea has right heart catheterization showing mean pulmonary artery pressure 28 mmHg, pulmonary capillary wedge pressure 10 mmHg, and pulmonary vascular resistance 6 Wood units. Echocardiography shows no left heart disease or significant lung disease. Which WHO group of pulmonary hypertension is most likely?

• A Group 3: Pulmonary hypertension due to lung disease or hypoxia
• B Group 2: Pulmonary hypertension due to left heart disease
• C Group 1: Pulmonary arterial hypertension ✓
• D Group 4: Chronic thromboembolic pulmonary hypertension

Explanation

Pre-capillary pulmonary hypertension is defined as mean PAP greater than 20 mmHg, PCWP less than or equal to 15 mmHg, and PVR greater than 2 Wood units. With no left heart or lung disease, this meets criteria for Group 1 pulmonary arterial hypertension. Group 2 requires elevated wedge pressure.

Reference: European Respiratory Journal (ESC/ERS Guidelines), 2022 ed.

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Written and medically reviewed by the StethoPrep medical team.