Pulm Vascular Disease_Lect 19

Question 1

What is the formula for systemic arterial pressure? For pulmonary artery pressure?

Answer 1

Psa = (CO X SVR) + Pra
Ppa = (CO X PVR) + Pla
Ppa- Pla = (CO X PVR)

Question 2

Increased RV Afterload has 2 major detrimental outcomes?

Answer 2

Cardiogenic Shock and Decreased RCA blood flow

Question 3

What are some significant symptoms of PAH?

Answer 3

Low perfusion - syncope, dyspnea, angina, fatigue

congestion - abd pain/fullness, peripheral edema

Question 4

Significant findings in Physical Exam in PAH

Answer 4

JVP, RV heave, loud P2, TR murmur, RV s3/s4

Hepatomegaly, cool extremities, LE edema (No Rales)

Question 5

Most common cause of PAH?

Answer 5

Small PA vasculopathy

Question 6

Treatment Measures? Side effects of Vasodilators?

Answer 6

preload, O2 sat~90%, anticoag, digoxin, rehab to improve functional capacity
Surgery (atrial sept, thromboendarectomy)
Lung transplant

Vasodilator→HA, dizzy
ERAs→terato, periph edema, anemia
bosentan→liver tox
prostanoids→jaw pain, delivery problem