Pulmonary hypertension and Cor Pulmonale Flashcards
What is pulmonary hypertension?
Increased resistence and pressure in the pulmonary arteries. This therefore puts strain on the right side of the heart and then the systemic venous system
what is the definition of pulmonary hypertension?
Mean pulmonary arterial pressure > 20mmHg
What are the causes of pulmonary hypertension?
Group 1 - Idiopathic or connective tissue disease (SLE)
Group 2 - Left heart failure
Group 3 - Chronic lung disease.
Group 4 - Pulmonary vascular disease (PE)
Group 5 - Miscellaneous (sarcoidosis, glycogen storage disease and haematological disorders)
What are the signs and symptoms of pulmonary hypertension?
Shortness of breath,
Fatigue,
Syncope,
Raised JVP,
Parasternal have,
Loud P2,
Presence of S3,
Pansystolic murmur (tricuspid regurg),
End-diastolic murmur (pulmonary regurg)
What are the investigations for pulmonary hypertension?
ECG: P pulmonale (peaked P waves), RVH, RAD, RBBB.
Right heart catheterisation: gold standard
Chest X ray: Dilated pulmonary arteries, RBH
Others: Raised NT-proBNP, ECHO
What is the management of pulmonary hypertension?
Treat underlying cause.
If idiopathic then give CCBs, IV prostaglandins, endothelin receptor antagonists or phosphodiesterase-5 inhibitors
What is cor pulmonale?
Right sided heart failure causes by pulmonary hypertension
What are the causes of cor pulmonale?
COPD,
PE,
ILD,
Cystic fibrosis,
Primary pulmonary hypertension.
What is the presentation of cor pulmonale?
Shortness of breath,
Peripheral oedema,
Exertional breathlessness,
Syncope,
Chest pain
What are the signs of cor pulmonlae?
Hypoxia, cyanosis, raised JVP, peripheral oedema, third heart sound, murmur, ascites, hepatomegaly (pulsatile)
What is the management of cor pulmonale?
Treat underlying cause and subsequent symptoms.
Oxygen treatment
