This slides contains case based & guideline directed management of Pulmonary Hypertension.

1. Journal Club
19-09-2017
Dr. Azim Anwar
Brown Unit
Dept of Internal Medicine
BSMMU

2. Shikha Datta, 27 years old, admitted on
BSMMU with the complain of Shortness of
Breath on exertion, which was progressively
increasing day by day over the last 1 year. 1
year back she admitted on BSMMU with
bilateral leg swelling and was diagnosed as
APS and since then she is been treated with
Warfarin and Hydroxychloroquine.

3. On Examination
• Distressed
• Anemic
• Bilateral pitting ankle edema
• JVP Raised
• Loud P2
• Pan Systolic Murmur at left sternal edge with
no radiation.
• Other examination findings are normal.

4. Investigation
• Color Doppler Echocardiogram:
Severe TR, Mild PR
RA, RV dilated,
Severe PHTN (PASP 110mmhg)
EF 62%

5. Diagnosis
• Pulmonary hypertension due to- ???
 Chronic thromboembolic Disease
Congenital Shunt
Primary Pulmonary Hypertension

13. Investigations

21. Treatment

43. What We Did ???

44. Advise for
 TEE
CTPA
Vasoreactivity test

45. Discharge Treatment
• Tab. Ambrisentan 5mg, 1+1+1+1
• Tab. Tadalafil 10mg, 0+0+4

46. THANK YOU