Question

A 41-year-old woman presents due to worsening symptoms. She was diagnosed with idiopathic pulmonary hypertension about 2 years prior to presentation; she is on home oxygen therapy. She has longstanding fatigue and dyspnea, but she is now experiencing profound dyspnea with exertion; swelling in her ankles; some discomfort in her right, upper abdomen; and the inability to breathe well when lying down. She has always been thin, but her weight has increased by 10 pounds in the last month. She denies fever and chills.

She recently had an electrocardiogram (ECG), but she has not seen a healthcare provider to discuss the results. The ECG report indicates peaked p waves, right axis deviation, and tall R wave in V1.
What is the most appropriate intervention for her current condition?

1. Prescribe a calcium channel blocker, such as verapamil
2. Prescribe a diuretic, such as furosemide
3. Prescribe a fluoroquinolone, such as levofloxacin
4. Prescribe a lipase inhibitor, such as orlistat
5. Prescribe a thiazolidinedione, such as actose

Answer 1

A woman with idiopathic pulmonary hypertension experiencing worsened symptoms, including dyspnea and edema, should be 2)prescribed a diuretic, such as furosemide, to alleviate fluid overload and improve her symptoms.

Step-by-step explanation:

The 41-year-old woman diagnosed with idiopathic pulmonary hypertension presenting worsening symptoms such as profound dyspnea with exertion, swelling in her ankles, discomfort in her right upper abdomen, and orthopnea is likely experiencing right heart failure due to increased pressure in the pulmonary circulatory system.

The findings on her electrocardiogram (ECG) of peaked p waves, right axis deviation, and a tall R wave in V1 are consistent with right ventricular hypertrophy, commonly seen in pulmonary hypertension patients. The most appropriate intervention for her current condition would be the prescription of a diuretic.

such as furosemide, to reduce the fluid overload causing her symptoms of edema and contribute to her breathing difficulties.