pulmonary hypertension

Question 1

what is pulmonary hypertension?

Answer 1

elevated blood pressure in the pulmonary arterial tree
-> leads to cor pulmonale (right heart failure)

secondary to chronic lung disease e.g. COPD

Question 2

what is the mean pulmonary artery pressure of pulmonary hypertension at rest?

Answer 2

> 25mmHg

Question 3

what are the causes of pulmonary hypertension?

Answer 3

• idiopathic/ connective tissue disease
• chronic arterial stenosis
  e.g. chronic unresolved pulmonary embolism, congenital pulmonary artery stenosis
• chronic respiratory disease e.g. COPD, restrictive lung disease, sleep apnoea
• left heart disease e.g. chronic kidney disease, haemolytic anaemia, sarcoidosis
• multifactorial e.g. left ventricular systolic/ diastolic failure, mitral stenosis (narrowing)

Question 4

what are 6 presentations of pulmonary hypertension?

Answer 4

• chest tightness
• exertional dyspnoea
• haemoptysis
• peripheral oedema
• syncope (loss of consciousness for a short period)

Question 5

what are the signs of pulmonary hypertension?

Answer 5

• clubbing
• fluid retention e.g ankle oedema, ascites, elevated JVP
• hepatomegaly (liver enlargement)
• loud pulmonary second heart sound
• right ventricular parasternal heave
  -> cause right ventricular hypertrophy