PS-C32-2: PRECAPILLARY PULMONARY HYPERTENSION IN ENUGU, NIGERIA AETIOLOGY, CLINICAL FEATURES AND RISK FACTORS

Abstract

Objective: Pulmonary hypertension is characterized by a progressive and sustained increase in pulmonary vascular resistance which eventually may lead to right heart failure. Echocardiography can be used to diagnose pulmonary hypertension, and CT pulmonary angiography can be used to confirm the cause in most patients. Precapillary pulmonary hypertension includes WHO Clinical Groups 1, 3, 4 and 5. Data on the causes of pulmonary hypertension are lacking in our environment, and we set out to identify the common causes, clinical features and the risk factors. Design and Method: Consecutive patients who had moderate to severe pulmonary hypertension on transthoracic echocardiography in the absence of left heart disease were recruited for the study from July 2015 to April 2022. All the patients were expected to do CT pulmonary angiography to determine the cause of the pulmonary hypertension. The case notes of patients who had done CT pulmonary angiography were retrieved and retrospectively reviewed, and demographic data, presenting complaints, physical signs, and associated clinical conditions extracted. Results: A total of 82 patients met the inclusion criteria, but only 46 did CT pulmonary angiography. The age range of the latter group was from 24 to 80 years with a mean age of 50.35 ± 12.43 years. Chronic thromboembolic pulmonary hypertension (CTEPH) was noted in 30 patients (65%), out of which 24 (80%) are females. Idiopathic cases and VSD Eisenmenger were the next common causes. Breathlessness on exertion, cough and syncopal attacks were the commonest presenting features. The presence of uterine fibroids was a frequent association with CTEPH. Conclusion: Chronic thromboembolic pulmonary hypertension is the commonest cause of pre capillary pulmonary hypertension, and is basically a disease of middle aged women in Nigeria. Breathlessness on exertion and syncopal attacks are common symptoms, and the presence of uterine fibroids is strongly associated with its presence.