Pulmonary hypertension

Question 1

What are the 5 groups of pulmonary hypertension?

Answer 1

1. Pulmonary ARTERIAL hypertension (disease of small pulm arteries)
2. Left heart disease
3. Lung disease/chronic hypoxic state
4. Chronic pulm hypertension (chronic PE)
5. Multifactorial

Question 2

What causes intrinsic pulmonary hypertension?

Answer 2

Idiopathic
Connective tissue disease
HIV
ASD/VSD

Question 3

Which specific pathologies causes left sided heart pulm HTN?

Answer 3

LV systolic/diastolic dysfunction
(aortic/mitral disease)
Mitral stenosis or regurg

Question 4

Which chronic lung pathologies cause pulm HTN?

Answer 4

COPD
Interstitial lung disease
OSA

Question 5

What causes multifactorial pulm HTN?

Answer 5

Sarcoid
Chronic haemolytic anaemia e.g. sickle cell
CKD
Gauchers disease

Question 6

What are the principles of treating pulmonary hypertension?

Answer 6

Oxygenate
Give fluid if underfilled
Treat underlying cause of precipitation
Consider dobutamine/milrinone early