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Distressing Dyspnea in a Patient with Lupus

Authors
Aaron Miller, MD; Pulmonary/Critical Care Fellow, Saint Louis University School of Medicine
John Mwangi, MD; Assistant Professor, Division of Pulmonary, Critical Care and Sleep Medicine, Director of Pulmonary Hypertension Program, Saint Louis University School of Medicine


Discussion

Intro

A 59 year old female with history of systemic lupus erythematosus (SLE) presented to pulmonary clinic with worsening dyspnea on exertion. Echocardiography (ECHO) was obtained which showed normal systolic function with estimated ejection fraction of 60%. The estimated right ventricular systolic function (RVSP) was 48 mmHg. Right heart catheterization (RHC) was subsequently obtained. The pertinent RHC waveforms are included below. The pulmonary artery (PA) waveform is on the left and the pulmonary artery wedge pressure (PAWP) waveforms are on the right.

Echocardiography

The patient’s cardiac output was measured to be 4.17 Liters/min by the thermodilution method. The mean pulmonary artery pressure is 33 mmHg.

Question

Based on this information, what is the pulmonary vascular resistance (PVR) for this patient?

Answer