pulmonary hypertension pre and post capillary pressures
- related: pulmonary hypertension
- tags: #permanent
- source: Murray and Nadel Textbook of Respiratory Medicine
Pulmonary hypertension is defined as mean pulmonary artery pressure greater than 20 mmHg on right heart cath, with normal around 14 ± 3 mmHg, making 20 mmHg greater than 2 standard deviation above mean (normal right heart catheterization pressures).
Patients with elevated PCWP belong to group 2 (left heart disease) or group 5 (mixed or unclear), different from other groups that generally have decreased PCWP (pulmonary hypertension clinical classifications). Use diastolic pulmonary gradient (PAP Diastolic - PCWP) to get accurate measurement of precapillary PH in patients who are volume up, after diuresis:
- DPG = PAP diastolic - PCWP > 7 = precapillary
In mixed pre and post capillary pHTN, you can find whether it’s more heart issues vs pulmonary issues. HFpEF with borderline PCWP, for example, would have less group 2 PHTN. Use both echo and RHC to determine.
Use mPAP and cardiac output to determine if patient has exercise pulmonary hypertension:
RHC Graph
