Question

the diagnosis of pulmonary hypertension associated with chronic obstructive pulmonary disease (copd) is suspected when which of the following is noted? select all that apply. right ventricular enlargement left ventricular hypertrophy elevated plasma brain natriuretic peptide (bnp) enlargement of central pulmonary arteries dyspnea and fatigue disproportionate to pulmonary function abnormalities

Explanation:

1. Right ventricular enlargement: Pulmonary hypertension (PH) due to COPD causes increased pressure in the pulmonary circulation, leading to right ventricular strain and subsequent enlargement. So this is a sign.
2. Left ventricular hypertrophy: PH associated with COPD primarily affects the right side of the heart, not the left. Left ventricular hypertrophy is more related to left - sided heart issues like hypertension or coronary artery disease, so this is not a sign.
3. Elevated plasma brain natriuretic peptide (BNP): BNP is released in response to ventricular stretch. In PH - related right ventricular strain, BNP levels can be elevated, so this is a sign.
4. Enlargement of central pulmonary arteries: In PH, the increased pressure in the pulmonary circulation can lead to the enlargement of central pulmonary arteries, so this is a sign.
5. Dyspnea and fatigue disproportionate to pulmonary function abnormalities: In PH associated with COPD, the symptoms of dyspnea and fatigue can be more severe than what would be expected from the COPD - related pulmonary function changes alone, due to the added burden of the pulmonary vascular disease, so this is a sign.

Answer:

• Right ventricular enlargement
• Elevated plasma brain natriuretic peptide (BNP)
• Enlargement of central pulmonary arteries
• Dyspnea and fatigue disproportionate to pulmonary function abnormalities