Which breath sound may be present in pulmonary hypertension?

• A. Wheezing
• B. Crackles
• C. Pleural friction rub
• D. Rhonchi

Answer: (B)

Crackles can appear in pulmonary hypertension when there is venous congestion and fluid buildup in the lung interstitium or alveoli. The extra fluid causes the small airways to snap open during inspiration, producing the fine, crackling sounds heard on auscultation. This finding reflects interstitial edema or edema-related changes that can accompany PH or related right-heart failure. In contrast, wheezing points to airway narrowing or bronchospasm, a friction rub to pleural inflammation, and rhonchi to secretions in larger airways, which are not typical primary features of pulmonary hypertension.