Study of the clinical and etiological profile of pulmonary hypertension

 

 

Abstract              Background: Pulmonary hypertension (PH) refers to the presence of high pulmonary vascular pressure and can be result of variety of different underlying disorders. PH is defined as increase in mPAP of 25mmhg or more. There is a vast difference between the etiologies of pulmonary hypertension as quoated in the western literature and there are only few Indian studies done to evaluate the spectrum of causes of Pulmonary Hypertension in our Indian setting. This study was carried out at our institution in the medicine department as inspite of being a tertiary care centre with super speciality departments most of the cases are treated by medicine department, right from diagnosis to the treatment. We have a large number of patients (inpatient/outpatient) who have pulmonary hypertension due to wide spectrum of causes including cardiac like congenital and valvular heart diseases and pulmonary like chronic obstructive and interstitial lung diseases. Hence a systematic study to obtain the pattern and etiological spectrum was undertaken with focus on presentation and clinical profile, 2D echo findings, severity of disease and the classification of pulmonary hypertension. Methodology: It was a prospective observational study carried out in patients admitted at a tertiary care center. Results: The most common aetiology of pulmonary hypertension in our study was valvular heart disease WHO class II (95/163, 58.28%) ;followed by COPD WHO class III (36/163, 22.08%) ;followed by Pulmonary Arterial Hypertension WHO class I (8/163, 4.91%); followed by Chronic Thromboembolic Pulmonary Hypertension WHO class IV (8/163, 4.91%). Only 3/163 cases (1.84%) belonged to WHO class V. 75 patients had moderate grade of PH (46.01%), 48 patients (29.45%) had mild grade and 40 patients (24.54%) had severe grade of PH on 2D echo.

Key Word: pulmonary hypertension.