cause of this pt's dyspnea - woodywoodpecker

[ArchivalUser]

A 55-year-old woman is undergoing evaluation of
dyspnea on exertion. She has a history of hypertension
since age 32 and is also obese with a body mass index
(BMI) of 44 kg/m2. Her pulmonary function tests show
mild restrictive lung disease. An echocardiogram shows a
thickened left-ventricular wall, left-ventricular ejection
fraction of 70%, and findings suggestive of pulmonary
hypertension with an estimated right-ventricular systolic
pressure of 55 mmHg, but the echocardiogram is technically
difficult and of poor quality. She undergoes a right
heart catheterization that shows the following results:
What is the most likely cause of the patient™s dyspnea?
A. Chronic thromboembolic disease
B. Diastolic heart failure
C. Obstructive sleep apnea
D. Pulmonary arterial hypertension
E. Systolic heart failure

[ArchivalUser]

cc? cardiac cat results are... ?

[ArchivalUser]

RESULTS DR WOODY???

[ArchivalUser]

bb

[ArchivalUser]

correct answer is B.

[ArchivalUser]

why not d? i hope u post the explanation,thanks

[ArchivalUser]

where is missing part of the question?it says: She undergoes a right heart catheterization that shows the following results:So where are the results?

[ArchivalUser]

i hope someone sees this q and post the explanation.....aint get it! ?

[ArchivalUser]

In the diagnostic algorithm for pulmonary hypertension,the right heart catheteriztion is imp to document the presence and degree of pulmonary hypertesion.The right ventriculart systolic pressure (RVSP) on echocardiography provides an estimate of pulmonary arterial pressure,but accurate determination of the RVSP relies upon the presence of tricuspid regurg and good quality echocardiography.In this pt,her body habits is prohibitive in obtaining good windows for echocardiography.Thus,a right heart catheterization is imperative for documenting pulmonary Hypertension as well as for determining the cause.The right heart catheterization demonstrates an elevated mean arterial pressure, elevated left ventricular end diastolic pressure(PCWP),and elevated mean pulmonary artery pressure.In th erpesence of a normal cardiac output and an elevated left ventricular ejection fraction,this is consistent with the diagnosis of diastolic heart failure.Systolic heart failure is ass with similar indices on right heart catheterization,but left ventricular function is depressed in systolic heart failure.The other causes listed as options are known causes of pul hypertension but would not be expected to cause an increase in the left ventricular end diastolic pressure.Obstructive sleep apnea is usually associated only with mild elevations in pul artery pressure.This pt's BMI puts er at risk for obstructive sleep apnea but would not be reponsible for these right heart catheterization values.Both chronic thromboembolic disease and pulmonary arterial hypetension can cause severe elevations in the pulmonary arterial pressure but have a normal left atrial pressure.

[ArchivalUser]

The missing part of the q din get posted for which I apolgise.