08.25 - Pulmonary Hypertension (Muthiah) - Questions Flashcards
Test critical to confirming and quantifying PAH
Right Heart Catheterization
Commonest cause of pulmonary HTN
Pulmonary Venous HTN (post capillary)
Definition of PAH
Mean PAP > 25mmHg at rest (Mean PCWP&LVEDP <15)
Alveolar hypoxemia causes what remodeling change
Vasoconstriction –> Chronic thickens vessels
Group 1 PAH
iPAH, Heritable (BMPR2), HIV-related, CTDz
Group 4 PAH
Chronic Thromboembolic
Group 5 PAH
Multifactorial etiology
Most important vasoconstrictor
Endothelin 1
Prostacyclin vs TXA2
Anti-coagulant vs Coagulant
Which Collagen Vascular Disease is most often associated with PAH
Systemic Sclerosis
Importance of Raynaud’s
Conditions with Raynauds often have PAH
Thrombocytosis and PAH
Increased 5-HT
10% of what hemoglobinopathy is associated with PAH
Sickle Cell - Free Hb and Iron implicated
Gene and protein to remember for Familial PPH
PPH1 –> BMPR2
History of what emphasized class of medications is important to obtain in patient with suspected PAH?
Stimulants, such as Fen-Phen, Cocaine, etc
TXA and Prostacyclin in PPH
Increased TXA, Decr Prostacyclin
Nitric Oxide promotes vasodilation and
inhibits SM growth
Endothelin 1 in PAH (and 5-HT)
Vasoconstrictor and Mitogen for SM cells - Localises in PAH
Vasoconstrictor and Mitogen for SM cells - Localises in PAH
Endothelin 1 in PAH
Role of Serotonin in PAH
Vasoconstriction and SM Cell proliferation; Plasma concentrations higher in PAH
Role of V-gated K Channels in PAH
Lower mRNA in PAH - Low channel current - Incr in intracellular Ca2+ - Vasoconstriction
Why is intracellular Ca2+ incr in PAH
Low v-gated K channels
Appetite suppressant drugs may generate PAH by
blocking v-gated K channels
Role of appetite suppressant drugs
May generate PAH by blocking v-gated K channels
