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Cardiovascular Pathophysiology > Pulmonary and Systemic Hypertension > Flashcards

Pulmonary and Systemic Hypertension Flashcards

1
Q

what are the clinical signs of pulmonary hypertension?

A

dyspnea
fatigue
syncope

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2
Q

is the right ventricle more adapted to increased volume or increased pressure?

A

increased volume more than increased pressure

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3
Q

what does right ventricle dilation lead to?

A

tricuspid regurgitation

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4
Q

what are the common causes of pre-capillary, pulmonary arterial hypertension?

A

idiopathic
congenital heart disease (with left to right shunt)
heartworm infection

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5
Q

what is affected by pulmonary arterial hypertension?

A

pulmonary arterial system alone

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6
Q

what is the general cause of pulmonary arterial hypertension (pre-capillary)?

A

disorders that cause the arterial system to remodel and imbalance between vasodilation and vasoconstriction (endothelial dysfunction)

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7
Q

what is endothelial dysfunction?

A

imbalance between vasodilators and vasoconstrictors produced by endothelial cells

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8
Q

why is poiseuille’s equation important?

A

change in radius of a vessel causes a giant change in pressure
radius is to fourth power

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9
Q

what makes up pulmonary arterial remodeling?

A

intimal hyperplasia
medial hypertrophy
adventitial proliferation

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10
Q

what is pulmonary hypertension from with left-sided heart failure (post-capillary)?

A

pressure in left atrium passively transmitted backwards to pulmonary veins, capillaries, and even arteries

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11
Q

what are some causes of pulmonary thromboembolism in dogs and cats?

A

neoplasia
metabolic disease
trauma
surgery
renal disease

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12
Q

what are some endothelin-receptor antagonists?

A

bosentan
ambrisentan
macitentan

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13
Q

what does phosphodiesterase 5 do?

A

breaks down cGMP (important in vasodilation)

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14
Q

how can we deliver nitric oxide to the patient?

A

nitroprusside
nitroglycerine paste

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15
Q

what are some phosphodiesterase 5 inhibitors?

A

sildenafil
tadalafil
vardenafil

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16
Q

what are the neural controls of vasodilation and vasoconstriction?

A

sympathetic and parasympathetic systems

17
Q

what does right ventricle dilation lead to?

A

tricuspid regurgitation

18
Q

what is group 2 of pulmonary hypertension?

A

post-capillary, pulmonary venous hypertension secondary to left-sided heart disease

19
Q

what are some causes of chronic thromboembolism that lead to pulmonary hypertension (group 4)?

A

heartworm infection
pulmonary thromboembolism
neoplasia

20
Q

what happens with arterial remodeling?

A

pilmonary arteriolar remodeling: intima, media, adventitia
thrombus formation
inflammation
plexiform lesions
imbalance between vasodilation and vasoconstriction

21
Q

what are plexiform lesions?

A

capillary-like vascular channels within lumen of small muscular arteries

22
Q

what are some lung diseases in dogs that can lead to pulmonary hypertension?

A

interstitial fibrosis
sleep apnea
chronic hypoxia

23
Q

what do endothelin-receptor antagonists do?

A

block endothelin receptor: prevent vasoconstriction

24
Q

what are the types of systemic hypertension?

A

situational
secondary (most common)
idiopathic

25
Q

what humoral regulators vasodilate?

A

nitric oxide
histamine
prostacyclin

26
Q

what does hydralazine do?

A

inhibits calcium release in smooth muscle cells: decreases systemic hypertension

27
Q

what can be used to inhibit RAAS to decrease systemic hypertension?

A

ACE inhibitor or angiotensin receptor blocker: enalapril, benazepril, losartan

28
Q

what are some things that cause pulmonary hypertension through lung disease or hypoxia (group 3)?

A

interstitial lung disease
chronic exposure to high altitude

29
Q

what in heartworm leads to pulmonary arterial hypertension?

A

endarteritis
villous proliferation

30
Q

why is it a problem that pulmonary arteries experience high blood flow in left-to-right shunting?

A

proliferative changes in arteries
increase in pulmonary vascular resistance

31
Q

can pulmonary hypertension secondary to left-sided heart failure lead to pulmonary arterial remodeling?

A

yes

32
Q

how can direct destruction of the vascular bed from lung disease happen?

A

stress from hyperinflation
inflammation

33
Q

how does lung disease cause pulmonary hypertension?

A

chronic hypoxia: increased vascular resistance
direct destruction of vascular bed from lung disease
pulmonary artery remodeling
endothelial dysfunction

34
Q

how can we treat pulmonary hypertension?

A

fix underlying cause if possible
try to dilate pulmonary vessels

35
Q

what are some humoral regulators that vasoconstrict?

A

catecholamines
endothelin
ADH/vasopressin
renin-angiotensin-aldosterone system

Cardiovascular Pathophysiology (35 decks)

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