Pulm Vascular Disorder: Pulmonary HTN Flashcards
What is pulm HTN? >_____mmHg?
persistant and sustained pulm arterial pressure > 25 mmHg
What is the normal pressure pulm circuit?
~15mmHg
The pulm circuit is ______ and has low _____ therefore low _______ and minimal increase in pulm pressure if _____ _______ increases
compliant
pressure
resistant
CO
Pulm ___________—–> increase ________.
vasconstriction
pressure
If no longer compliant, anything that causes ________ will persistently ________ pressure
constriction
increase
At nonpeak time, the heart is pumping at ____ and blood is distributed through the circuit with no real _____ in ________
rest
increase
pressure
At peak time, the _____ _____ increases and more _____ goes thru the ______ and there’s some ______ in _______
heart rate
blood
arteries
increase, pressure
What happens, then there is a break in one or two vessels? In peak time and nonpeak time?
PROBLEM:
pressure in pulm circuit increases
nonpeak time: congestion in vessels
peak time: even more congestion
Etiology: _____% is mostly d/t ______ and ______ problems
95%
cardiac and pulm
Etiology: What are the 3 categories of cardiac and respiratory prob that leads to pulm HTN?
- hypoxemia
- increase pulm blood volume
- increase pulm venous pressure
Etiology: Why does hypoxemia cause pulm HTN?
in systemic hypoxemia, the pulm circuit vasoconstrict b/c if dilated more CO2 are added to the circulation and distributed to the rest of the body worsening hypoxia elsewhere
drop in O2—> vessels in pulm circuit _____ —> increase ______
constrict
pressure
in systemic hypoxemia in all tissue/organs besides lung there is _________ to increase _______ ______ to all tissues to receive more ______
vasodilation
blood flow
oxygen
Etiology: increase in pulm _______ ______ —> more blood —-> increase _______
blood volume
pressure
Etiology: Explain how septal defect cause pulm HTN?
in fetal dev, the foramina is an opening that closes during brith, if not closed, there is open communication from L and R ventricles and –> blood goes thru the aorta and pulm arteries —> blood vol increases in pulm circuit—> pulm HTN
In fetal life, do they use they lungs? Explain.
In fetal life, there lungs collapse and there is no blood flow in pulm circuit. They draw O2 from maternal blood and passing CO2 in maternal blood
Etiology: In pulm HTN, there is an ____ in pulm _______ pressure.
increase
venous
Etiology: Explain how mitral valve stenosis contribute to increase pulm venous pressure.
mitral valve is stiff and do not open easily —> blood coming thru from pulm circuit into the L atrium cannot empty fully into L ventricle–> there is residual volume in L atrium —> congestion of blood in venous circuit increase pressure in pulm circuit
What is happening in the R ventricle in pulm HTN?
d/t build up of pressure—> R ventricle pump against increase resistance —> build up of pressure and volume –> more congestion and less blood return
Manifestations (7) Explain each
- dyspnea: associated with hypoxia
- fatigue: d/t inadeq perfusion
- syncope: d/t inadeq perfusion in brain
- chest pain on exertion: d/t decrease CO
- those of RHF: d/t heart pumping against increase resistance in pulm circuit
- distended pulm arteries: d/t increase pressure/volume in cardiac and pum circuit–> dilation in pulm artery
- RV hypertrophy: d/t R-sided HF
How does decrease CO lead to angina?
CO decreases–> less perfusion in pulm circuit –> form of angina
How does RHF result from pulm HTN?
the heart is persistently pumping against increase resistance in pulm circuit d/t increase pressure –> RHF
Why is there hypertrophy in RV?
RHF–> R ventricle pumps against increase resistance –> increase size in muscle cells — RV hypertrophy
Treatment of pulm HTN (3)
- address underlying cause
- Ca channel blockers
- prostacyclin
How does CCB tx pulm HTN?
calcium is required for muscle contraction–> if Ca channels are blocked muscles cannot contract—> muscle relaxes relieving pressure
What are prostacyclin and how does it tx pulm HTN? When is it used?
A form of prostaglandins 12 and is used as a potent vasodilators to relieve pressure
When pt is non responsive to CCB
