A Patient with Class III Obesity and a Body Mass Index of 70.1 kg/m2 Requiring Pulmonary Artery Catheterization to Confirm the Diagnosis of Pulmonary Hypertension

Background: Intensive care management of patients with morbid obesity has been linked to a higher mortality rate than that of the normal population and can be challenging. Obesity is a recognized risk factor for pulmonary hyper-tension, but it can prevent cardiac imaging. This report presents the case of a 28-year-old man with class III (morbid) obesity, a body mass index (BMI) of 70.1 kg/m2, and heart failure, requiring pulmonary artery cathe-terization (PAC) to confirm the diagnosis of pulmonary hypertension. Case Report: A 28-year-old male patient with a a body mass index (BMI) of 70.1 kg/m2was admitted to the Intensive Care Unit (ICU) for the management of respiratory and cardiac failure. The patient had class III obesity (BMI >50 kg/m2) and heart failure. Due to the difficulties in evaluating hemodynamic status via echocardiography, a pulmonary artery catheter (PAC) was placed, revealing a mean pulmonary artery pressure of 49 mmHg, and a diagnosis of pulmonary hypertension was made. The alveolar partial pressures of oxygen and carbon dioxide were op-timized by ventilatory management to reduce pulmonary vascular resistance. The patient was extubated on day 23 and was discharged from the ICU on day 28. Conclusions: Pulmonary hypertension should be considered in the evaluation of obese patients. Using a PAC during the in-tensive care management of a patient with obesity could aid in the diagnosis of pulmonary hypertension as well as cardiac dysfunction, determine treatment strategies, and evaluate hemodynamic responses to various therapies.