The following is a summary of “Etiology of pulmonary hypertension in multiple myeloma: A case series and literature review,” published in the January 2023 issue of Pulmonology by Desmarais, et al.

Pulmonary hypertension frequently exacerbates multiple myeloma through a variety of processes. The mechanisms included congestive heart failure, chronic thromboembolic pulmonary hypertension (CTEPH), pulmonary hypertension (PH) brought on by concurrent cardiac amyloid, high output heart failure brought on by anemia or lytic bone lesions, and chronic thromboembolic pulmonary hypertension (CTEPH). The case study series demonstrated the numerous pathways for people with multiple myeloma to experience pulmonary hypertension. Therefore, for a study, researchers sought to determine the causes of pulmonary hypertension and how to treat it in patients with multiple myeloma receiving care at the University of California, San Diego.

Finding individuals with multiple myeloma and pulmonary hypertension who received evaluations at the University of California, San Diego, between July 2013 and July 2021 required a retrospective chart analysis. Patients also needed to have a right heart catheterization. In addition, the chart review provided information on pulmonary hypertension’s demographics, comorbidities, clinical trajectory, and etiology.

Eleven patients were included. Out of the 11 patients mentioned, two had pulmonary hypertension (PH) caused by cardiac amyloid, 1 by high output heart failure, 1 by CTEPH, 2 by pulmonary arterial hypertension brought on by drugs (carfilzomib), and 5 by PH caused by congestive heart failure. The numerous mechanisms of PH in multiple myeloma were outlined based on the results of a right heart catheterization and echocardiography.

Pulmonary hypertension is a typical sign of multiple myeloma that calls for further testing. An extensive drug review and echocardiography should be part of the first examination. The patient’s medical history should serve as a guide for any additional diagnostic procedures, which may include right heart catheterization, cardiac biopsies, ventilation-perfusion scans, and bone scans.

Reference: resmedjournal.com/article/S0954-6111(22)00336-5/fulltext