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ECHO 325 > Pulmonary Hypertension > Flashcards

Pulmonary Hypertension Flashcards

1
Q

How is pulmonary hypertension characterized?

A

Elevated pulmonary arterial pressures and secondary RV failure

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2
Q

As right heart pressures rise to moderate or severe levels, the RV almost always shows reduced what?

A

FAC, TAPSE, and s’ values

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3
Q

If PC is high, where is the problem?

A

LA

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4
Q

If PC is low, where is the problem?

A

RV

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5
Q

Describe pre-capillary PHTN values:

A

mPAP: >25mmHg
PCWP: ≤15mmHg
PVR: ≥3 wood units

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6
Q

Describe post-capillary PHTN values:

A

mPAP: >25mmHg
PCWP: ≥15mmHg

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7
Q

What are respiratory symptoms of PHTN? (5)

A
  • SOB
  • Coughing
  • Wheezing
  • Hemoptysis
  • Intercostal retraction
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8
Q

What are signs of right side heart failure? (4)

A
  • Jugular vein congestion
  • Peripheral edema
  • Ascites
  • Hepatosplenomegaly
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9
Q

What are associated cardiac symptoms of PHTN? (5)

A
  • Palpitations
  • Chest pain
  • SOBOE
  • Orthopnea
  • Syncope
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10
Q

What is the normal RA and IVC pressure?

A

0-4 mmHg

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11
Q

What is the normal RV sys/diast pressure?

A

<25/<10

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12
Q

What is the normal pulmonary artery syst/diast pressure?

A

<25/<10

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13
Q

What is the RVSP with pulmonary hypertension?

A

> 35-40 mmHg

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14
Q

What is the most common cause of right sided heart failure?

A

Left side heart failure

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15
Q

What are two general pulmonary causes of elevated Rt sided pressures?

A

Parenchymal and vascular diseases

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16
Q

Acute pulmonary embolism is most often caused by what?

A

DVT

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17
Q

What is Eisenmenger’s Syndrome?

A

Shunt reversal in patients with significant shunt that have developed PHTN as a result

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18
Q

Chronic volume overload leads to what?

A

Permanent lung damage which raises pulmonary pressures

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19
Q

What direction does a heart shunt go and what direction does eisenmenger’s syndrome go?

A

Regular shunt = Left to right

Eisenmenger’s = Right to left due to high pulm pressures causing PHTN from the normal shunt they had originally

20
Q

Anything that causes pressure or volume overload to the RV will lead to what?

A

RVH, and RV and TV annular dilation (TR)

21
Q

Chronic elevation of RT heart pressures often lead to what? (3)

A
  • Dilated coronary sinus (veins in RA)
  • Reopening of the PFO (patent foramen ovale)
  • Dilated main PA
22
Q

Post capillary PHTN usually involves what?

A

LV systolic dysfunction, LV diastolic dysfunction, or valvular disease

23
Q

Paradoxical septal motion (septal bounce) appears as what, and could be caused by what?

A

Appears as a double dip, may be caused by RBBB or LBBB

24
Q

RVPO is the etiology that causes what?

A

Increased PRESSURE to the right heart

25
Q

RVVO is the etiology that causes what?

A

Increased VOLUME to the right heart

26
Q

PSAX D-sign is only seen when with RVVO?

A

Diastole

27
Q

PSAX D-sign is seen when with RVPO?

A

Both systole and diastole

28
Q

Describe what is used to calculate PAH with SPAP (RVSP)?

A
  1. Using the TR maximum vel + RAP

2. Using VSD peak velocity

29
Q

Describe what is used to calculate PAH with MPAP?

A
  1. Using PW in the PA + RAP

2. Using PR early diastolic velocity (CW or PW)

30
Q

Describe what is used to calculate PAH with PAEDP?

A
  1. Using PR end-diastolic velocity
31
Q

Severe TR will appear as what on the spectral trace?

A

Dense, triangular

32
Q

When a VSD is present, what should we use to calculate the RVSP?

A

VSD Jet

33
Q

If we take the blood pressure and minus the pressure gradient from the VSD jet, what can we estimate?

A

RVSP

34
Q

Describe the formula if we were to estimate RVSP using a VSD:

A

RVSP = SBP - (4Vvsd)2

35
Q

MPAP number should correspond to what?

A

PCWP

36
Q

MPAP = ?

A

MPAP = 79 - (0.45 X PAT) [Pulmonary acceleration time]

37
Q

The PG from the early diastolic velocity tells us what?

A

MPAP

38
Q

The RVEDP is estimated from what?

A

EDV of the PR jet

39
Q

Describe the normal SPAP (RVSP) value:

A

18-25 mmHg

40
Q

Describe the severe SPAp (RVSP) value:

A

> 70 mmHg

41
Q

Describe the normal value for RVOT-AT:

A

≥120 ms

42
Q

Describe the normal value for mPAP:

A

<25 mmHg

43
Q

Describe the severe RVOT-AT:

A

<60 ms

44
Q

Describe the severe mPAP:

A

> 50 mmHg

45
Q

Describe normal PAEDP:

A

4-12 mmHg

46
Q

What is Cor Pulmonale?

A

RV failure due to rising pressures from ejecting into a high resistance vascular bed causing RVH leading to dilation and failure

ECHO 325 (19 decks)

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