Pulmonary Hypertension Flashcards

1
Q

What is PH?

A

A disease of the small pulmonary arteries characterised by vascular proliferation and remodelling

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2
Q

What does PH result in?

A

It results in a progressive increase in pulmonary vascular resistance

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3
Q

What are the main vascular changes in PH?

A

Vasoconstriction, smooth-muscle cell and endothelial cell proliferation, thrombosis

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4
Q

What are pre-capillary causes of PH?

A

Multiple small PEs, left-to-right shunts, primary

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5
Q

What are capillary causes of PH?

A

Emphysema, COPD

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6
Q

What are post-capillary causes of PH?

A

Backlog of blood causes secondary PH, LV failure

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7
Q

What are chronic hypoxaemia causes of PH?

A

Living at high altitude, COPD

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8
Q

What are PH symptoms?

A

Exertional dyspnoea, lethargy and fatigue, ankle swelling

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9
Q

What are PH signs?

A

Accentuated pulmonic component to the 2nd heart sound, tricuspid regurgitation murmur, fatigue, peripheral oedema, cyanosis

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10
Q

What are first line tests?

A

CXR, ECG, trans-thoracic echocardiogram

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11
Q

What is the gold standard investigation?

A

Right heart catheterisation

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12
Q

What general supportive management would you start?

A

Treat underlying cause, oral anticoagulants, diuretics if fluid retention, supplemental O2, supervised exercise training, avoiding pregnancy

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13
Q

What management is there for treatment-resistant patients?

A

Balloon atrial septostomy, lung transplantation

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