FN: Pulmonary Hyptertension Flashcards
1
Q
Definition
A
PA pressure >25 mmHg
2
Q
Causes
A
Left Heart disease
Lung parenchymal disease
Pulmonary Vascular disease
Hypoventiliation
3
Q
Left Heart disease leading to pulmonary hypertension
A
Mitral stenosis
Mitral regurgitation
Left ventricular failure
L→Rshunt
4
Q
Lung parenchymal disease
A
Lung Parenchymal Disease Mechanism Chronic hypoxia → hypoxic vasoconstriction Perivascular parenchymal changes COPD Asthma: severe, chronic Interstitial lung disease CF, bronchiectasis
5
Q
Pulmonary Vascular disease
A
Idiopathic pulmonary hypertension Pulmonary vasculitis: scleroderma, SLE, Wegener’s Sickle cell Pulmonary embolism: acute or chronic Portal HTN: portopulmonary HTN
6
Q
Hypoventilaition
A
Ix OSA Morbid obesity (Pickwickian syn.) Thoracic cage abnormality: kyphosis, scoliosis Neuromuscular: MND, MG, polio
7
Q
Investigations
A
ECG
ECHO
Right heart catheterisation: gold standard
8
Q
ECG shows
A
P pulmonale RVH
RAD
9
Q
Echo
A
Velocity of tricuspid regurgitation jet
Right atrial or ventricular enlargement Ventricular dysfunction
Valve disease
10
Q
Right heart catheterisation: gold standard
A
Mean pulmonary artery pressure Pulmonary vascular resistance
CO
Vasoreactivity testing to guide Rx
