Pulmonary hypertension Flashcards
1
Q
What is normal mean pulmonary artery pressure?What is the upper normal limit?
A
14 +/- 3 mmHg
Upper limit 20
2
Q
What is pulmonary HTN defined as ?
A
mPAP above 25
3
Q
What are the 2 mechanisms that can lead to it
A
increase in pulmonary vascular resistance
increase in pulmonary blood flow
4
Q
What are causes of pulmonary HTN
A
PE Primary PH Veno-occlusive disease COPD OSA Cerebrovascular disease Cardiac - mitral stenosis, LVF, CHD
5
Q
How does it present
A
Exertional dyspnoea, lethargy and fatigue Ankle swelling CP Syncope Hepatic congestion - oedema, abdo pain
6
Q
What can be found on examination
A
Loud pulmonary second sound
R parasternal heave due to rvh
7
Q
what are features of advanced disease
A
RHF (cor pulmonale):
- Elevated JVP
- Prominent V wave
- Hepatomegaly
- Pulsatile liver
- Peripheral oedema
- Ascites
- Pleural effusion
8
Q
What is seen on CXR
A
enlarged pulmonary arteries
big heart
may reveal cause: emphysema, calcified MV
9
Q
What Is seen on ECG
A
RVH + p pulmonale (tall peaked P wave)
10
Q
What tests would u do
A
CXR
ECG
Echo
LFTs - portal HTN
11
Q
What is treatment
A
underlying cause oxygen warfarin diuretics Bosenten PPD5i Inhaled iloprost
