Pulmonary hypertension Flashcards
What is the definition of ‘Pulmonary hypertension’?
Defined as resting mean pulmonary artery pressure of > 25 mmHg
What are the 3 mechanisms of pathophysiology of Pulmonary Hypertension?
- Pulmonary vascular remodelling
- Abnormal muscularisation
- Thickening of pulmonary arteriolar wall
What do the thickening of the pulmonary artery wall cause the formation of?
Formation of complex ‘plexiform lesions;
Name 5 symptoms of ‘Pulmonary hypertension’?
- Breathlessness
- Weakness / lethargy
- Exertional dizziness
- Syncope
- Anginal chest pain
Signs of pulmonary hypertension
- Raised JVP with large V wave
- Loud P2
- Right ventricular heave
- Murmur of tricuspid regurg
- Peripheral oedema
What is ‘Primary pulmonary hypertension’
- Elevated pulomnary artery pressure
2. No identified cause
Who is ‘Primary pulmonary hypertension’ most common in?
Greatest number of cases in women aged 21 - 40
What is ‘Secondary pulmonary hypertension’ due to?
- Cardiac disease
- congential heart defects
- atrial septal defects - Lung disease
- COPD
- Pulmonary fibrosis
How many groups can ‘Pulmonary arterial hypertension’ be divided into?
PAH is divided into 5 groups
What is Group 1 PAH?
Pulmonary arterial hypertension (PAH), which can be idiopathic (IPAH) or associated with other conditions, notably systemic sclerosis and congenital heart disease
What is Group 2 PAH?
Pulmonary hypertension owing to left heart disease
What is Group 3 PAH?
Pulmonary hypertension owing to lung disease or hypoxia or both
What is Group 4 PAH?
Chronic thromboembolic pulmonary hypertension?
What is Group 5 PAH?
Unclear or multifactorial mechanisms
What investigations are performed in Pulmonary hypertension?
- ECG
- Chest x ray
- Pulmonary function tests
- ECHO
- Right heart catheter
