pulm. hypertension

Question 1

def. pulm HT

Answer 1

• elevation of mean pulm art. pressure
• > 25 mmHg
• caused y probs anywhere in pulm circulation

Question 2

def. pulm. arterial hypertension

Answer 2

• narrowing of the small pulm arteries and arterioles
• lead to vasc. resisitance
• right heart >25mmHg, AND normal left heart

Question 3

5 anatomic sites for PHT

Answer 3

1. pulm. artery
2. pulm arteriole
3. pulm caps
4. pulm veins
5. L heart

Question 4

NICE classification

Answer 4

5 groups

1. arteriole (PAH) and veno-occlusive (PVOD)
2. left heart
3. resp diseases
4. pulm arterey
5. misc

Question 5

what are features of PAH

Answer 5

• idiopathic
• genetic
• drug and toxin induced
  associated with
• CT disease
• HIV
• portal HT

Question 6

epi of PAH

Answer 6

• rare
• F>M
• low survivial if not treated

Question 7

4 steps for diagnosis of pulm HT

Answer 7

1. resp and cardiac Sx
2. risk for PAH
   - famHx, toxic drugs, CTD, HIV , liver disease
3. risk for other 4 types
4. physical findings of pulm HT

Question 8

5 investigations of pulm HT

Answer 8

1. look for resp disease
   - walk test, PFT, CXR
2. look for underlying predisposing causes
3. look for cardiac disease
   - ECG
4. look for VTE disease
5. measue pulm. pressures

Question 9

5 Tx for pulm HT

Answer 9

1. treat underlying cause if one
2. diuretics for R heart failure
3. O2
4. heart of lung transplant
5. specific vasodilator therapy for PAH

Question 10

3 possible vasodilator therapies

Answer 10

1. endothelin antagonsits
2. PDE-5is
3. prostacyclines