Pulmonary Hypertension Flashcards
What are five etiologies of pulmonary hypertension?
-Idiopathic
-COPD
-Mitosis and regurgitation
-pulmonary embolism
-obesity (picwinckin syndrome)
What is pickwinckin syndrome?
A blood condition with there is a lack of oxygen in the blood, and there is more carbon dioxide.
What’s another name for pickwickin syndrome?
OHS
Obesity hypoventilation syndrome
A patient has a huge dilated pulmonary artery, severe TR and right ventricular enlargement best describes?
- Pulmonary embolus
2.PHTN
3.MR - MI
- PHTN
An increase in pulmonary artery pressure of ____ indicates pulmonary hyper?
> 30mmhg
I what is Eisenmenger syndrome?
Where a long-standing left to right shunt reverses due to pulmonary hypertension, and then becomes a right to left shunt
List 4 pathophysiology effects of pulmonary hypertension?
-hypoventilation (OHS)
-Resistance to venous drainage
-Resistance to blood flow
-Resistance to pulmonary artery flow
What are two physical signs of pulmonary hypertension?
-fatigue
-Dyspena
What are 5 echo signs of pulmonary hypertension?
-Flying ‘w’ due to decreased a wave and/or mid systolic closure of PV
- RVH
-RA & RV dilation
-Flattening of the IVS at the LV level in PSAX due to RV volume overload - paradoxical LV septal motion
What is represented with a decreased a wave and a flying W on m-mode?
PHTN
With a small pulmonary embolism, the heart may be?
Normal
With a large pulmonary embolism, the ____ & ___ will ___ and there may be ___ or ___ systolic dysfunction present.
RV & RA ; dilate ; PHTN ; RV
Given a tricuspid regurgitation with 60mmhg gradient. Grade the severity of pulmonary hypertension.
- none
2.mild
3.moderate - Severe
- Severe
What is the McConnell sign?
When the RV free wall is akinetic but the RV apex is still squeezing normally or Hyperkinecticlly
What is the normal peak pulmonary artery pressure?
18 to 40 mmhg
What is the mild peak pulmonary artery pressure?
40-54mmhg
What is the moderate peak pulmonary artery pressure?
55-64mmhg
What is the severe peak pulmonary artery pressure?
> 65mmhg
What 3 things should you do with Doppler for pulmonary hypertension?
- PR
-TR ( measure peak TR for RVSP) - measure systolic acceleration time of pulmonary flow
How do you measure systolic acceleration time of pulmonary flow?
When you PW the pulmonic valve in short axis, you will measure the acceleration time like you would have a decel time
What is the normal systolic acceleration time of pulmonary flow?
> 120msec
What is a abnormal systolic acceleration time of pulmonary flow that indicates PHTN?
<75msec
Your patient has PHTN with a dilated IVC of 3 cm which collapsed 50% with a sniff estimate the RA pressure
- 3mmhg
- 8mmhg
- 15mmhg
- 20mmhg
- 8mmhg
