Pulmonary Hypertension Flashcards
What is the definition of pulmonary HTN?
Pulmonary arterial pressure > 25 mmHg
How many grades are in the Heath and Edwards grading system? What is its purpose?
6; Determine if arterial changes of pulm. HTN could be reversed with cardiac surgery; 1 - 3 reversible, 4 - 6 not reversible
What causes cor pulmonale?
Increased pressure in the lesser circulation leads to hypertrophy of the RV
A muscular pulmonary artery shows occlusive intimal fibrosis. What is the Heath and Edwards grade?
Grade 3
Plexiform lesions consisting of irregular interlacing blood channels, dilation and thinning of pulmonary arteries is shown. What is the Heath and Edward Grade?
Grade 4
What is found in Heath and Edward Grade 6?
Fibirinoid Necrosis of arteries and arterioles
What are the conditions that fall under precapillary HTN?
- L-R cardiac shunt
- Primary Pulmonary HTN
- Thromboembolic pulmonary HTN
- HTN due to fibrotic lung disease and hypoxia
What are the conditions that fall under postcapillary HTN?
- Pulmonary veno-occlusive disease
- HTN secondary to left-sided cardiac disorders (ie mitral stenosis, aortic coarctation)
What causes primary pulmonary HTN? In this case, what do patients normally die from?
Increased pulmonary arterial tone; Cor pulmonale
What is Pickwickian Syndrome?
Severe obesity that impedes breathing
How can Pickwickian Syndrome and Kyphoscoliosis cause pulmonary HTN?
Both conditions -> Hypoventilation -> Hypoxemia -> Vasoconstriction of Small Pulm. Arteries -> Pulm HTN
How does mitral insufficiency lead to pulm HTN?
Mitral stenosis/insufficiency -> LA regurgitation -> Pulm Venous congestion -> Pulm Artery congestion -> HTN
A patient presents with progressive dyspnea and CXR reveals scattered lung infiltrates. The biopsy of a pulmonary vein is shown below. What is the Dx? What is the cause of this disease?
Veno-occlusive disease of the lung; Uncertain etiology but possibly viral infection, toxic agents, and chemoTx
