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Year One - Respiratory System > Pulmonary Hypertension > Flashcards

Pulmonary Hypertension Flashcards

1
Q

What is pulmonary hypertension?

A

It is defined as an increased blood pressure within the pulmonary arteries, specifically a mean arterial pressure greater than 25mmHg at rest

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2
Q

What is the pathophysiological result of pulmonary hypertension?

A

This increased pressure in the pulmonary arteries results in an increased strain on the right side of the heart and a back pressure of blood into the systemic venous system

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3
Q

What are the two classifications of pulmonary hypertension?

A

Primary Pulmonary Hypertension

Secondary Pulmonary Hypertension

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4
Q

What is primary pulmonary hypertension?

A

It is defined as pulmonary hypertension which is not related to an underlying cause

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5
Q

What is secondary pulmonary hypertension?

A

It is defined as pulmonary hypertension due to an underlying condition

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6
Q

What is the subclassifications of secondary pulmonary hypertension based on?

A

The specific underlying aetiology

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7
Q

What is group one secondary pulmonary hypertension?

A

Pulmonary hypertension related to connective tissue disease

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8
Q

What connective tissue disease is associated with pulmonary hypertension?

A

SLE

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9
Q

What is group two secondary pulmonary hypertension?

A

Pulmonary hypertension related to left heart disease

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10
Q

What is group three secondary pulmonary hypertension?

A

Pulmonary hypertension related to chronic lung disease

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11
Q

What three chronic lung diseases are associated with pulmonary hypertension?

A

COPD

Interstitial lung disease

Obstructive sleep apnoea

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12
Q

What is group four secondary pulmonary hypertension?

A

Pulmonary vascular disease

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13
Q

What pulmonary vascular disease is associated with pulmonary hypertension?

A

Pulmonary embolism

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14
Q

What is group five secondary pulmonary hypertension?

A

Pulmonary hypertension related to miscellaneous conditions

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15
Q

What three miscellaneous conditions are associated with pulmonary hypertension?

A

Sarcoidosis

Glycogen storage disorder

Haematological disorders

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16
Q

What ten clinical features are associated with pulmonary hypertension?

A

Dyspnoea

Syncope

Chest Pain

Peripheral Oedema

Tachycardia

Loud Pulmonary Component of S2

Third Heart Sound

Parasternal Heave

Increased JVP

Hepatomegaly

17
Q

What is the main presenting clinical feature of pulmonary hypertension?

A

Dyspnoea

18
Q

What are the clinical features of pulmonary hypertension related to?

A

The gradually worsening right ventricular function

19
Q

What four investigations are used to diagnose pulmonary hypertension?

A

ECG Scan

Chest X-Ray (CXR)

Echocardiogram Scan

Right Heart Catheterisation

20
Q

What is the first line investigation used to diagnose pulmonary hypertension? Why? However, what is important to remember?

A

ECG scan

It is a quick bedside investigation that can be conducted

It doesn’t provide a definitive diagnosis of pulmonary hypertension. In addition, normal results don’t exclude a diagnosis

21
Q

In general, how does pulmonary hypertension present on an ECG scan?

A

There are features of right ventricular strain

22
Q

What are the four signs of pulmonary hypertension on ECG scans?

A

Peaked R Waves in V1 – V3

Peaked S Waves in V4 – V6

Right Axis Deviation

Right Bundle Branch Block

23
Q

What do peaked R and S waves indicate on an ECG scan?

A

Right ventricular hypertrophy

24
Q

What are the two signs of pulmonary hypertension on CXR?

A

Dilated Pulmonary Arteries

Right Ventricular Hypertrophy

25
Q

What investigation is used to provide a definitive diagnosis of pulmonary hypertension?

A

ECHO scan

26
Q

How are ECHO scans used to diagnose pulmonary hypertension?

A

They allow an estimated pulmonary arterial pressure to be obtained

27
Q

What other investigation is used to provide a definitive diagnosis of pulmonary hypertension?

A

Right heart catheterisation

28
Q

How is right heart catheterisation conducted?

A

It involves the insertion of a catheter into the pulmonary artery

29
Q

How are right heart catheterisations used to diagnose pulmonary hypertension?

A

They allow an estimated pulmonary arterial pressure to be obtained

30
Q

In what four ways do we manage primary pulmonary hypertension?

A

IV Prostanoids

Endothelin Receptor Antagonists

Phosphodiesterase Inhibitors

Cardiopulmonary Transplant

31
Q

Name a prostanoid used to manage primary pulmonary hypertension

A

Epoprostenol

32
Q

Name two endothelia receptor antagonists used to manage primary pulmonary hypertension

A

Bosentan

Macitentan

33
Q

Name a phosphodiesterase inhibitor used to manage primary pulmonary hypertension

A

Sildenafil

34
Q

How is secondary pulmonary hypertension managed?

A

We treat the underlying cause

Year One - Respiratory System (14 decks)

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