Pulmonary vascular disease Flashcards
What is a pulmonary embolism?
Pulmonary embolism is the sudden blockage of a major blood vessel (artery) in the lung, usually by a blood clot.
Symptoms of pulmonary embolism
- Pleuritic chest pain, cough and haemoptysis
- Isolated acute dyspnoea
- Syncope or cardiac arrest (massive PE)
Signs of pulmonary embolism
- Pyrexia, pleural rub, pleural effusion
- Tachycardia, tachpnoea, hypoxia
- Tachycardia, hypotension, tachypoea, hypoxia
What is a pulmonary infarction?
It occurs when a section of lung tissue dies because its blood supply has become blocked.
Techniques used to investigate pulmonary embolisms
- Full blood count, biochemistry, blood gases
- Chest X-ray
- ECG
- D-dimer
- CT Pulmonary Angiogram (CTPA)
- V/Q scan
- Echocardiography
What treatment is used for pulmonary embolism?
- Oxygen
- Warfarin
- Low molecular weigh heparin
- Direct oral anticoagulants
- Thrombolysis
- Pulmonary embolectomy
What is Pulmonary Hypertension?
Elevated blood pressure in the pulmonary arterial tree.
Is primary or secondary pulmonary embolism more common?
Secondary pulmonary hypertension is more common and tends to occur in an older age group.
Causes of pulmonary hypertension
- Idiopathic
- Secondary to chronic respiratory disease
- Secondary to left heart disease
- Chronic thromboembolic PH (CTEPH)
- Miscellaneous
Symptoms of pulmonary hypertension
- Exertional dyspnoea
- Chest tightness
- Exertional presyncope or syncope
Signs of pulmonary hypertension
- Elevated JVP (jugular venous pressure)
- Right ventricular heave
- Loud pulmonary second heart sound
- Hepatomegaly
- Ankle oedema
Techniques used to investigate pulmonary hypertension
- ECG
- Lung function tests
- Chest X-ray
- Echocardiography
- V/Q scan
- CTPA
- Right heart catheterisation
Specific treatments for pulmonary hypertension
- Calcium channel antagonist
- Prostacyclin
- Endothelin receptor antagonists
- Riociguat
- Phosphodiesterase inhibitors
General treatments for pulmonary hypertension
- Treat underlying condition
- Oxygen
- Anticoagulation
- Diuretics
Other treatments for pulmonary hypertension
- Thromboendarterectomy (CTEPH)
- Lung or heart transplant
