I have a few minutes now so I can elaborate. During the diagnostic Right Heart catheterization, a Wedge pressure reading is taken. That is done by the surgeon’s wedging a tiny latex balloon into the pulmonary artery and measuring the pressure against it. If the Wedge pressure (PAWP) is OVER 15, then the patient definitely is in Group 2. If the reading is 14 or 15 but the patient has a history of cardiac issues, then a further test called a Fluid Challenge is done during that same RHC. Fluid is forced into the artery at specific intervals and with specific amounts. If that increases the pressure reading to above 18, then the person in fact is in Group 2.
I was initially classified as Group 1 but we got a new head of my PH Clinic who went over everybody’s charts and picked up on some anomalies. I do have a history of heart disease but my wedge was only 14 initially. He had me take another RHC and this time we also did the Fluid Challenge which drove my pressure up to 28!
Not every doctor who does RHCs knows how to do the Fluid Challenges or knows to check for those anomalies. If you haven’t already had your RHC, it is important to have yours done by somebody who has done a LOT of them and who is truly proficient in PH…Preferably somebody tied to a PH Clinic.
There are 5 subgroups and each has a different treatment protocol. The groups and treatments are not interchangeable at all. I am Group 2, Left Heart Disease. Group 2 is diagnosed in a Right Heart Catheterization by getting a Wedge pressure reading over 15. Wedge pressure is also referred to as PAWP.
I was initially misclassified as Group 1. When it was corrected I had to be taken off the Group 1 meds and start following the Group 2 protocol.
Great question! Pulmonary hypertension (PH) is organized into 5 groups based on what causes it. Here's a breakdown of Groups 1 and 2:
Group 1 – Pulmonary Arterial Hypertension (PAH)
This is when the arteries carrying blood from your heart to your lungs become narrow, stiff, and inflamed, making it harder for blood to flow Show Full Answer