Pulmonary HTN Flashcards
What is considered pulmonary HTN?
Mean pulmonary arterial pressure > or = 25 mmHg at rest
OR
> 30mmHg during exercise
What is normal pulmonary pressure?
<20 mmHg
What is Type I pulmonary HTN?
Idiopathic; primary =diagnosis of exclusion
What is Type II pulmonary HTN?
due to left heart disease
What is Type III pulmonary HTN?
due to hypoxemic or chronic lung disease (COPD)
What is Type IV pulmonary HTN?
due to chronic thromoembolic disease
A patient with COPD is likely to have which Stage of pulmonary HTN?
Stage III
What population is at a higher risk for Primary pulmonary HTN?
MC in middle-aged or young women
-mean age at diagnosis is 50y
What defect is most responsible for primary pulmonary HTN?
BMPR2 gene defect
-BMPR2 gene normally inhibits pulmonary vessel smooth muscle growth and vasoconstriction—> with this defect the patient is unable to inhibit vasoconstriction, thus leading to HTN
What is the 2nd MCC of pulmonary HTN?
COPD
What are other causes of pulmonary HTN you should be aware of?
- Sleep apnea
2. PE
A patient is seen in the clinic for increasing dyspnea. On PE, you hear an accentuated S2 and notice an increased JVP, peripheral edema and ascites. EKG reveals right atrial enlargement, a right bundle branch block, RVH and right axis deviation. What could you expect this patients lab results (CBC) to reveal?
Polycythemia with increased hematocrit
What EKG reading is indicative of Cor pulmonale?
RVH and right axis deviation
A patient is seen in the clinic for increasing dyspnea. On PE, you hear an accentuated S2 and notice an increased JVP, peripheral edema and ascites. EKG reveals right atrial enlargement, a right bundle branch block, RVH and right axis deviation. CBC lab reveals Polycythemia with increased hematocrit. What is the most definitive method to diagnose this patient?
Right-sided heart catheterization -gold standard*
What is the management for pulmonary HTN if they are vasoreactive?
If vasoreactive : CCB 1st line
