Pulmonary Hypertension Flashcards
Pulmonary circulation is a system of _ resistance?
Low resistance
The RV is a _ pressure _ _ pump.
low pressure, high volume.
Pulmonary blood vessels are more _ than systemic vessels.
Compliant
Pulmonary hypertension is
Increased pulmonary artery pressure
How many clinical classifications are there for PHTN?
5, but we focus on group III and group IV
What is group III PHTN?
Lung disease + chronic hypoxia
What is group IV PHTN?
Chronic thromboembolism
What is the normal pulmonary arterial systolic pressure?
Lower than 30 mmhg
Increased vascular resistance leads to…
increase RV workload
Explain supply/demand mismatch
Increased O2 demand, your body compensates with increasing CO, but CO can’t accommodate for exertion due to increased pulmonary resistance and weak RV, leading to dyspnea, angina, claudication.
Think of walking up the stairs.
Explain what happens in peripheral fluid overload
RV hypertrophies due to worsening pulmonary resistance. The RV dilates which leads to RV heart failure (Cor pulmonale). This leads to peripheral fluid build up.
What are the etiologies for PHTN?
Chronic
- Chronic obstructive p. disease.
- Restrictive disease
- Chronic thromboembolism
- Tumor growth
Acute
- Thromboembolism
Explain the pathophysiology of the etiologies of PHTN
-Physical obstruction of blood flow, causing an increased vascular resistance
-Loss of pulmonary capillaries, causing lower capacity for blood flow leading to higher pressure in vessels.
- Lung parenchyma becomes stiffer increasing vascular resistance.
- Chronic hypoxia+ acidosis causing increased resistance.
What are the symptoms of PHTN?
Fatigue, dyspnea, angina, cough, syncope, swelling.
What clinical findings would you see with a pt. with PHTN?
-Jugular venous distention
-Abnormal heart sounds (P2)
-Hepatomegaly
-Edema
