2.2.3 Pulmonary Vascular Disease Flashcards
Why does pulmonary arterial hypertension end up killing patients?
Patients don’t die from increasing pulmonary pressures; they die from progressive right heart failure.
What is the role of prostacyclin in PAH?
Where are the main regions that emboli originate from?
What are the symptoms of a PE?
What is this an image of? What are the defining characteristics?
What is the role of endothelin-1 in PAH?
As Dr. Wood said in the lecture in cardio, there is no stronger vasoconstrictor than endothelin. In PAH, it is thought that levels of endothelin-1 are elevated
What are the signs of PAH?
JVD
Trouble catching breathe
Periperial Swelling
What are the two categories or problems that cause pulmonary edema?
What is the pathology of PAH?
78y/o woman come to ED with shortness of breath, orthopnea, and paroxysmal nocturnal dyspnea. She has a history of coronary artery disease and systemic hypertension. She is admitted for pulmonary edemaand treated with diuretics. If she were to undergo right heart cath at this time what would be found?
B
How does the NO pathway have a role in PAH?
PDE5 degrades cGMP not allowing it to ellicit its effects on smooth muscle
What is the abnormality in this image?
Its a PE!
Why do thrombi form?
- Blood stasis
- Hyper-coagulable states
- Vessel wall abnormalities
What is this an image of?
MASSIVE PE
What is this an image of?
Lung tissue with pulmonary edema
What is a pulmonary embolism?
25 y/o presents to your clinic with complaints of dyspnea, lower extremity edema and chest pressure. On exam, you see bilateral lower extremity pitting edema and JVD. Her lungs are clear to auscultation bilaterally.
B. Fixed splitting of the pulmonic component of the second heart sound
What is pulmonary arterial hypertension defined as?
39 y/o male was riding mountain bike and fell. He was admitted to surgery and repaired his broken femur. Surgery went well and he is sent home in a cast. He come back to the ED 3 days later with shortness of breath that came on suddenly. What is the most likely diagnosis?
Acute pulmonary embolus
What is the pathophysiology of pulmonary edema?
What happens when a PE occurs?
How do the lungs protect themselves from excessive movement of fluid into interstitial spaces?
What are the normal pulmonary hemodynamics?
What are the symptoms of pulmonary edema?
Yes it does.
Her PA pressure is greater than 25 and her wedge pressure is lower than 15
What are some of the etiologies of PAH?
What is this an image of?
Normal pulmonary artery and alveolus
What is the effect of alveolar edema on size?
It makes them larger
What is this an image of?
Alveolar edema
What is the cause of death from a PE?
Cardiovascular collapse, rather than resp failure
How do you diagnose of DVT or PE?
What is this?
Normal lung tissue
