Fast Five Quiz: Pulmonary Arterial Hypertension

Zab Mosenifar, MD

Disclosures

June 14, 2019

Clinical manifestations of PAH may include the following:

  • History of heart murmur

  • Deep venous thrombosis or pulmonary embolism

  • Raynaud phenomenon

  • Arthritis or arthralgias

  • Rash

  • Heavy alcohol consumption

  • Hepatitis

  • Heavy snoring

  • Daytime hypersomnolence

  • Morning headaches

  • Morbid obesity

  • Family history of pulmonary hypertension

  • Drug use, in particularly diet drugs and illicit drugs

  • Medications

Patients with PAH may also have nonspecific symptoms secondary to pulmonary hypertension. These may include the following:

  • Dyspnea on exertion

  • Fatigue

  • Lethargy

  • Syncope with exertion

  • Chest pain

  • Anorexia

  • Right upper quadrant pain

Less common symptoms include the following:

  • Cough

  • Hemoptysis

  • Hoarseness (resulting from compression of the recurrent laryngeal nerve by the distended pulmonary artery)

The intensity of the pulmonic component of the P2 may be increased, and the P2 may demonstrate fixed or paradoxical splitting. A systolic ejection murmur may be heard over the left sternal border. The murmur may be augmented by inspiration. A right ventricular heave may be palpated.

Although PAH has been associated with thyroid dysfunction, the most common association is with hyperthyroidism.

Read more on PAH.

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