Pulmonary hypertension

Question 1

Definition of pulmonary hypertension?

Answer 1

Pulmonary arterial pressure >25mmHg

Question 2

Group 1

Answer 2

Pulmonary arterial hypertension- idiopathic or associated with a connective tissue disease e.g. scleroderma

Question 3

Group 2

Answer 3

Left heart disease- valvular, heart failure, congenital

Question 4

Group 3

Answer 4

Lung disease e.g. COPD, interstitial lung disease

Question 5

Group 4

Answer 5

Chronic thromboembolic disease e.g. pulmonary emboli, sickle cell disease

Question 6

Group 5

Answer 6

Unclear/multifactorial

Question 7

Definition of cor pulmonale

Answer 7

Right heart failure resulting from pulmonary hypertension

Question 8

Specialist investigation of suspected pulmonary hypertension? (3)

Answer 8

Echocardiography
Right heart catheterization
Assessment of functional capacity e.g. 6 minute walk test

Question 9

General management options for pulmonary hypertension? (3)

Answer 9

Management of underlying cause
Diuretics
Oxygen (if indicated)

Question 10

Specific options for Group 1 pulmonary arterial hypertension? (4)

Answer 10

Calcium channel blockers
PDE5 inhibitors e.g. sildenafil
Prostacyclin analogues e.g. iloprost
Endothelin receptor antagonists e.g. bosentan

Question 11

Specific option for group 4 PH?

Answer 11

Pulmonary endarterectomy

Question 12

Surgical options for PH? (2)

Answer 12

Heart/lung transplant

Atrial septotomy