Pulmonary Hypertension Flashcards
what is pulmonary hypertension
^ resistance and pressure of blood in the pulmonary arteries
what is the effect of pulmonary hypertension
- causes strain on right side of heart trying to pump blood through lungs
- causes back pressure of blood into systemic venous system
what are the causes of pulmonary hypertension
Group 1:
- primary pulmonary hypertension or CT disease e.g. systemic lupus erythematous (SLE)
Group 2:
- left heart failure usually due to MI or systemic hypertension
Group 3:
- chronic lung disease e.g. COPD
Group 4:
- pulmonary vascular disease e.g. pulmonary embolism
Group 5:
- miscellaneous causes e.g. sarcoidosis, glycogen storage disease, haematological disorders
give the signs and symptoms of pulmonary hypertension
- SoB
- syncope
- tachycardia
- raised JVP
- hepatomegaly
- peripheral oedema
what investigations can be done in suspected pulmonary hypertension
- ECG
- CXR
- raised NT-proBNP blood test result indicates right ventricular failure
- echo can be used to estimate pulmonary artery pressure
describe the ECG changes seen in pulmonary hypertension
right sided heart strain causes ECG changes:
- right ventricular hypertrophy
- -> larger R waves on right sided chest leads (V1-3) and S waves on left sided chest leads (V4-6)
- right axis deviation
- right bundle branch block
describe the CXR changes seen in pulmonary hypertension
- dilated pulmonary arteries
- right ventricular hypertrophy
what is the management of primary pulmonary hypertension
- IV prostanoids e.g. epoprostenol
- endothelin receptor antagonists e.g. macitentan
- phosphodiesterase-5 inhibitors e.g. sildenafil
what is the prognosis of pulmonary hypertension
30-40% 5 year survival from diagnosis
can ^ 60-70% where specific treatment is possible
management of secondary pulmonary hypertension
treating the underlying cause such as pulmonary embolism or SLE
can also have supportive treatment for complications such as respiratory failure, arrhythmias, HF
