Pulmonary Hypertension Flashcards
Pulmonary Hypertension
What is it?
a pathological condition defined by elevated blood pressure in the pulmonary arteries
Pulmonary Hypertension
What can the pressure elevation in the pulmonary arteries lead to?
right heart failure and decreased oxygen delivery to the body
Pulmonary Hypertension
How is it diagnosed, and using what method?
the mean pulmonary arterial pressure is greater or equal to 25 mmHg at rest, as measured by right heart catheterisation.
Pulmonary Hypertension
Pulmonary hypertension can be categorised into 5 groups based on the underlying causes:
- Pulmonary Arterial Hypertension (PAH)
- PH due to Left Heart Diseases
- PH due to Lung Diseases and/or Hypoxia
- Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
- PH with Unclear Multifactorial Mechanisms
Pulmonary Hypertension
What can cause Pulmonary Arterial Hypertension (PAH)?
- Idiopathic
- heritable
- drug-induced
- associated with other diseases (connective tissue, HIV infection, congenital heart)
Pulmonary Hypertension
What Left Heart Diseases may cause pulmonary hypertension?
- valvular diseases
- left ventricular systolic/diastolic dysfunction
Pulmonary Hypertension
What Lung Diseases may cause pulmonary hypertension?
- COPD
- ILD
- sleep apnoea
Pulmonary Hypertension
How do pts present?
- Dyspnoea
- Fatigue
- Chest pain
- Syncope
- Peripheral oedema
- Cyanosis
Pulmonary Hypertension
Which might be found on physical examination?
- Loud P2 (pulmonary component of the second heart sound)
- Right ventricular heave
- Jugular venous distension
- Tricuspid regurgitation murmur
- Hepatomegaly
Pulmonary Hypertension
What might an ecg show?
- right ventricular hypertrophy
- right axis deviation
Pulmonary Hypertension
What is the role of an Echocardiogram in investigating pulmonary hypertension?
essential in assessing the estimated pulmonary artery pressures, right ventricular function, and possible underlying left heart disease.
Pulmonary Hypertension
What can we use to investigate for to evaluate for chronic thromboembolic disease?
Ventilation/Perfusion (V/Q) Scan
Pulmonary Hypertension
What is the gold standard for confirming the diagnosis, measuring the pulmonary artery pressures directly, and assessing cardiac output?
right heart catheterisation
Pulmonary Hypertension
What Laboratory Tests might we order for a pt and why?
- **NT-proBNP ** indicative of cardiac strain
- autoantibodies if connective tissue disease is suspected.
Pulmonary Hypertension
What are the conservative measures for managing pulmonary hypertension?
- Low-level exercise
- oxygen therapy if hypoxemic
- pregnancy avoidance
