Profile of pulmonary hypertension in patients presenting with respiratory symptoms at a tertiary care hospital in Mumbai

Abstract

Background: Pulmonary hypertension (PH) is a disorder of the pulmonary vasculature caused due to vasoconstriction, vaso-destruction, or vaso-obliteration as a complication of a varied spectrum of diseases referred to a pulmonologist. We conducted this study to contemplate the profile of PH in a tertiary care hospital in Mumbai. Methodology: This was an observational study undertaken in the department of pulmonary medicine at a tertiary care center after internal ethical committee approval. Patients with respiratory symptoms referred to us with PH as estimated pulmonary artery systolic pressure (PASP) of ≥40 mmHg by transthoracic two-dimensional echocardiography (corresponding to mean pulmonary artery pressure of ≥25 mmHg) were included in the study. The profile of these patients was studied on basis of parameters such as demography, etiology, symptomatology, radiological features, 6-min walk distance (6-MWD), and spirometry. Data were analyzed using Microsoft Excel software. Results: Among 347 patients, 54% were men. Majority of the patients (53.5%) were aged between 45 and 65 years. The most common symptom was dyspnea (86%). The most common examination finding was loud pulmonary component of second heart sound (62%). The common etiologies of PH were postinfectious obliterative bronchiolitis (OB) 30%, interstitial lung diseases 26%, chronic obstructive pulmonary disease 24%, and obstructive sleep apnea 14%. There was a negative correlation between 6-MWD, forced vital capacity % predicted, forced expiratory volume in 1st s % predicted, and PASP. Conclusion: Airway disease is the most common etiology of PH in patients presenting to a pulmonologist in India, out of which postinfectious OB forms the major bulk.