Case of the Month #51 Pulmonary Hypertension

Published 18/07/2024

How is PH defined and how is the diagnosis confirmed?

Previously based on a mean pulmonary arterial pressure (mPAP) of ≥25 mmHg measured at right heart catheterisation. 

The mPAP cut-off has been reduced to 20 mmHg in the presence of other haemodynamic characteristics. There are 3 haemodynamic definitions: 

Definitions 

Characteristics 

Pre-capillary PH 

mPAP >20 mmHg 

PAWP ≤15 mmHg 

PVR >2 WU 

Isolated post-capillary PH 

mPAP >20 mmHg 

PAWP >15 mmHg 

PVR ≤2 WU 

Combined pre- and post-capillary PH 

mPAP >20 mmHg 

PAWP >15 mmHg 

PVR >2 WU 

mPAP – mean pulmonary arterial pressure 

PAWP – pulmonary arterial wedge pressure 

WU – Wood units, a unit of pulmonary vascular resistance. 1 WU

= 80 dynes/s/cm-5 

Gold standard for diagnosis is right heart catheterisation (RHC).