Pulmonary Hypertension

Question 1

Pulmonary hypertension

Answer 1

Increased blood pressure within arteries of the lungs.

Question 2

MPAP of Pulmonary Hypertension

Answer 2

MPAP > 25 mmHg

Question 3

Types

Answer 3

Pulmonary venous hypertension, pulmonary arterial hypertension.

Question 4

Causes of Pulmonary Arterial Hypertension

Answer 4

Hypoxia, multiple PEs, vascular is, drugs, HIV, Cardiac left to right shunt.

Question 5

Causes of Pulmonary Venous Hypertension

Answer 5

LV systolic dysfunction, mitral regurgitation/stenosis, cardiomyopathy.

Question 6

What type of hypertension leads to right heart failure?

Answer 6

Pulmonary Arterial Hypertension

Question 7

Pulmonary Arterial Hypertension

Answer 7

Primary disease of pulmonary arteries/arterioles

Question 8

Mechanisms of hypertension

Answer 8

Hypoxia, increased flow, blockage or loss of pulmonary vascular bed, back pressure from left side heart failure.

Question 9

Results in:

Answer 9

Medial hypertrophy of the arteries, fibrosis, atheroma, RH hypertrophy, plexogenic change/necrosis (extreme cases)

Question 10

Signs

Answer 10

Central cyanosis, dependent oedema, raised JVP with V waves, RV heave at left parasternal edge, Load P2, enlarged liver.

Question 11

Symptom of Pulmonary Arterial Hypertension

Answer 11

Progressive dyspnoea

Question 12

Investigations

Answer 12

Echo Doppler, ECG, DLCCO, VQ scan, D dimers

Question 13

Treatment for Pulmonary Arterial Hypertension

Answer 13

Prophylactic anticoagulaton, O2 if hypoxic, pulmonary vasodilator, lung transplant.