To Study the Clinical Profile of Pulmonary Hypertension
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 4
Abstract
This study being carried out in a tertiary care setting caring for patients with respiratory disorders attempts to study the clinical profile of patients with pulmonary hypertension in association with respiratory disorders and enhance our understanding of the same; more so as the study being carried out in Indian setting where diagnosis of pulmonary hypertension itself is lacking. Observational, open, single centric, parallel study. This study will be conducted in the tertiary care hospital of Mumbai & data for the patients of pulmonary hypertension will be procured from Medical Record Section for last one year. Prior start of this study, ethics committee approval will be taken. 100 patients of pulmonary hypertension (PH) will be enrolled in the study to get the significant results after calculating the power of the study. There are 64 males and 36 females. There are 28 smokers among this. 12 patients complained of chest pain among the study group. 16 patients presented with haemoptysis as their primary symptom. 30 patients presented with pedal edema of pitting variety. Among 100 patients 14 presented with syncope as their primary symptom. Totally 89 patients complained of cough as their initial symptom. 98 patients presented with X-ray alteration. In our study 93 patients complained of dyspnea. Among our patients 82 patients presented with fatigue. During the study period 7 patients who were symptomatic due to their cardiovascular problems, were cured following corrective surgery. 5 patients died during this period. 88 patients are still under treatment. In our study design majority were from class 3 being 76 followed by class 5, class 1 and class 4. The above study was an observational study of clinical profile of patients with pulmonary hypertension. In our study of 100 patients with pulmonary hypertension, men outnumbered women. Smoking is one of the major risk factor for respiratory etiology of pulmonary hypertension. The main symptoms at the diagnosis were chest pain (88%), dyspnoea (93%), followed by cough (89%), easy fatigue (82%), pedal oedema (30%), haemoptysis was complained by 84% of the patients. Syncope was present in only 14% patients. On respiratory examination, abnormality was found in almost all the cases except in 8 cases. 98 patients showed the x-ray abnormalities; most were the nonspecific findings. The composition of clinical classes according to Evian’s classification in our study was as following. Clinical class 1 had 9 patients, class 3 had 76 patients, class 4 had two patients and clinical class 5 contained 13 patients. Interestingly during our study period we never came across any type 2 cases. Men were outnumbered by women. There was significant delay between symptom onset and diagnosis of pulmonary hypertension. Dyspnoea and easy fatigue were the commonest symptoms. Physical examination findings for PH were less sensitive. Pedal oedema was present in significant number of patients despite absence of right heart failure. Chest radiograph had poor sensitivity in identification of pulmonary hypertension; however when present them signified RV dilatation and dysfunction. Clinical class 3 was the most predominant class. Obliterative bronchiolitis of post infectious aetiology was found to be single largest aetiology associated with pulmonary hypertension in clinical class 3 and overall.
Authors and Affiliations
Dr. Madhukar Gaikwad, Dr. Ramanand J Patil, Dr. Vikramjit R Padole, Dr. P. S. Tampi
Keywords
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