pulmonary vascular disease Flashcards
Where do 60-90% of PE originate?
in proximal deep veins of legs
What is virchow’s triad?
stasis, injury, hypercoaguability
risk factors for venous thromboembolism
What are teh medical risks associated with DVT?
hip knee surgery immobility CHF, obesity malignancy acquired hypercoaguability
What are teh nonspecific symptoms of pulmonary embolism?
dyspnea; acute or subacute dizziness, syncope: large PE chest pain-pleuritic palpitations, tachycardia hemoptysis
How do you diagnose venous thromboembolism?
DVT: doppler ultrasound
PE - V/Q scans
-CT pulm angiogram
What are group IV pulmonary hypertension?
chronic thrombotic, embolic disease
thromboembolic obstruction of proximal pulmonary arteris
-surgical candidates
obstruction of distal pulmonary arteries too
What is the group I PAH definition?
-mean pulmonary arterial pressure >25mmHg at rest with normal wedge pressure (PCWP) left heart filling pressure and
not Groups III, IV or V
What is the prognosis of pulmonary hypertension?
decreased RV function
poor prognosis determined by elevated RAP and low CO parameters
What gene is associated with heritable pulm arterial hypertension?
BMPR2 genetic mutations
What are associated with APAH?
collagen vascular disease: (Scleroderma, SLE, RA)
Congenital Heart Disease
portal hypertension, HIV, drugs
What are the pulmonary hypertension symptoms?
breathlessness fatigue near syncope, syncope (with exertion) chest pain:angina palpitations
What is the pathology of pulmonary arterial hypertension?
large pulm. artery thickening
medial wall smooth muscle hypertrophy
plexiform lesion in small vessel (specific to group I PAH disease)
What are the treatments for pulmonary arterial hypertension?
IV prostacyclin
Bosentan(endothelial receptor antagonist)
sildenafil (NO pathway, increase cGMP)
Riociguat (NO pathway, soluble guanylate cyclase stimulator)
What is the classic triad of alveolar hemorrhage syndromes?
hemoptysis
pulmonary infiltrates
anemia
What is the signs and symptoms of wegeners granulomatosis?
systemi vasculitis-granulomatous inflammation
(upper before lower respiratory and kidney)
nasal, sinus, otitis
cough, hemoptysis
constitutional
