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ANKI Respiratory > Pulmonary Vascular Disease > Flashcards

Pulmonary Vascular Disease Flashcards

1
Q

What is pulmonary vascular disease?

A

An increase in mean pulmonary arterial pressure >25mmHg at rest or >35mmHg with exercise

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2
Q

What can pulmonary hypertension be classified as?

A
  • Group I - Idiopathic
  • Group II - PH secondary to left heart disease
  • Group III - PH secondary to lung disease and hypoxia
  • Group IV - Chronic thromboembolic pulmonary hypertension
  • Group V - Pulmonary hypertension due to misc causes
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3
Q

What is the most common type of pulmonary hypertension?

A

Secondary to left heart disease

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4
Q

Is idiopathic pulmonary hypertension common?

A

No, it is rare

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5
Q

What happens to pressures in idiopathic pulmonary hypertension?

A

Increased pulmonary artery pressure, normal pulmonary capillary wedge pressure

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6
Q

How does idiopathic pulmonary hypertension present?

A
  • SOB on exertion

- Fatigue

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7
Q

What can cause type II pulmonary hypertension?

A

Systolic, diastolic, or valvular heart disease

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8
Q

What can cause type III pulmonary hypertension?

A
  • COPD
  • ILD
  • High altitutudes
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9
Q

How do patients with type IV pulmonary hypertension typically present?

A
  • SOB on exertion
  • Fatigue
  • Oedema
  • Angina type pain
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10
Q

What can cause type V pulmonary hypertension?

A
  • Sarcoidosis

- Histocytosis X

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11
Q

What confirms a diagnosis of pulmonary hypertension?

A

Right heart catheterisation

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12
Q

What other tests should be done in pulmonary hypertension?

A
  • Bloods
  • Autoimmune screening, esp for scleroderma
  • ECG
  • Spirometry
  • Echo
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13
Q

What does the management of pulmonary hypertension involve?

A

Treating underlying cause

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14
Q

How can the initial management of pulmonary hypertension be determined?

A

Carry out vasodilator testing

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15
Q

What should be offered in pulmonary hypertension if vasodilator testing positive?

A

Calcium channel blocker

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16
Q

What should be offered in pulmonary hypertension if vasodilator testing negative?

A
  • Prostaglandin analgoues
  • Endothelin receptor antagonists
  • Phosphodiesterase inhibitors
17
Q

What other management can be used in pulmonary hypertension?

A
  • Oxygen
  • Diuretics
  • Anticoagulation with warfarin
18
Q

What is cor pulmonale?

A

Alteration in structure and function of right ventricle secondary to lung disease

19
Q

What lung disease most commonly causes cor pulmonale?

A

Pulmonary hypertension

20
Q

What are the clinical features of cor pulmonale?

A
  • Worsening shortness of breath
  • Fatigue
  • Oedema
  • Haemoptysis
21
Q

What is the diagnosis of cor pulmonale made based on?

A

Echocardiography and right heart catheterisation

22
Q

What is found on ECG in cor pulmonale?

A

Right ventricular hypertrophy and peaked P waves

23
Q

What does treatment of cor pulmonale involve?

A
  • Treating underlying cause

- Stop smoking

24
Q

What are the further management options for cor pulmonale?

A
  • Long-term oxygen therapy
  • Diuretics
  • Long-acting calcium channel blocker, e.g. nifedipine
  • Transplantation in severe, intractable disease

ANKI Respiratory (17 decks)

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