3 years ago

Exertional dyspnoea in a 28-year-old woman

Clinical introduction

A 28-year-old woman with a history of critical pulmonic stenosis, status postsurgical valvotomy and subsequent pulmonary valve replacement, presented to the cardiology clinic with 1 year of progressive exertional dyspnoea. She has a heart rate of 75 bpm and blood pressure of 110/55 mm Hg. Cardiac auscultation reveals a 1/6 systolic ejection murmur along the left sternum and an early 3/6 diastolic decrescendo murmur. A transthoracic echocardiogram is obtained (figure 1).


Which of the following would be most likely found during right heart catheterisation?

  • Ratio of pulmonary to systemic blood flow (Qp:Qs) >1.5

  • Pulmonary vascular resistance >3 Wood units

  • Right atrial pressure >10mm Hg

  • Pulmonary artery systolic pressure >45mm Hg E. Pulmonary artery diastolic pressure <10mm Hg

  • Publisher URL: http://heart.bmj.com/cgi/content/short/103/22/1779

    DOI: 10.1136/heartjnl-2017-312174

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