Pulmonary hypertension Flashcards
1
Q
What mechanisms cause pulmonary hypertension?
A
- Incr flow to lungs (Eisenmenger)
- Lung disease (hypoxia, PA vasoconstriction)
- Decr flow out of lungs (left heart disease)
2
Q
Name causes of lung disease
A
Acute
Upper airway - croup
Lower airway - ARDS, infection, volume loss
Chronic Cop pulmonale (obstruction, restriction, destruction)
3
Q
Name causes of left heart failure
A
Obstruction
- Coarctation
- AS
- MS
- MR
Dysfunction
- DCMO
- Sepsis
- Ischaemia
- Hypoxia
- Bypass
4
Q
Name exacerbators of pulmonary hypertension
A
Hypercarbia Hypothermia Hypoglycemia Hypotension Hypovolemia Hypoxia Metabolic acidosis
5
Q
How do you treat a class 1 pulmonary hypertension?
A
INO
Prostacyclin
Sildenafil
Bosentan (long term)
6
Q
How do you treat a class 2 pulmonary hypertension?
A
Treat underlying cause
Manage complications
7
Q
How do you treat a class 3 pulmonary hypertension?
A
Optimize LHF
Support CO
8
Q
What are the clinical features of PHT?
A
Incr PBF RVH Palpable P2 Loud S2 LPH Epigastric heave
9
Q
What is pruning of the pulmonary arterial tree?
A
Smallest capillaries hypertrophy -> central proximal aa hypertrophy
