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Echo Lecture > Pulmonic And Systemic Hypertension > Flashcards

Pulmonic And Systemic Hypertension Flashcards

1
Q

What is central
Venous pressure?

A

The pressure of the superior and inferior vena cava. CVP=RAP

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2
Q

Causes of abnormal CVP/RAP

A
  • anything That creates volume/pressure overload can increase CVP
  • elevated RV systolic pressure (artery and lung htn)
  • TR from RA/RV overload
    -RV pressure overload, can cause RV dilation/hypertrophy
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3
Q

How do you estimate RAP/CVP?

A

1) measure IVC at end inspiration and end expiration
2) IVC size and difference in size during respiration est RAP

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4
Q

Values to determine RAP?

A

< 2.1 and > 50% = 3mmhg
< 2.1 and < 50% = 8mmhg
>2.1 and > 50% = 8mmhg
>2.1 and < 50% = 15mmhg

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5
Q

Symptoms/causes of heart failure from htn

A
  • Enlargement and failure of RV
  • caused by increased vascular resistance or high blood pressure in the lungs (PHTN)
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6
Q

2 types of heart failure

A
  • chronic cor pulmonale
  • Acute cor pulmonale
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7
Q

What is chronic cor pulmonale

A
  • develops gradually
  • associated with obstructive pulmonary disease
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8
Q

What is acute cor pulmonale

A
  • emergency situation
  • sudden dilation and dysfunction of RV
  • caused by pulmonary embolism
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9
Q

PHTN definition

A
  • A condition in which high blood pressure affects arteries of the lungs & right side of the heart
  • abnormal value for PHTN is > 25mmhg PAP
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10
Q

What is a pulmonary embolism

A

A condition in which a blood vessel in the lungs gets blocked by a blood clot

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11
Q

What causes pulmonary embolisms

A

Majority of pulmonary emoboli arise from a blood clot from deep vein thrombosis of the lower limb or other body parts

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12
Q

Symptoms of Pulmonary embolisms(non echo)

A
  • Shortness of breath
  • respiratory distress
  • chest pain
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13
Q

Echo findings that support pulminary embolism

A
  • severe RVE
  • elevated RVSP (due to clot restricting flow to lungs)
  • increases in TR
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14
Q

Causes of Systemic HTN

A

-overweight
- pregnancy
- excessive sodium consumption
- sleep apnea
- cv diseases like atherosclerosis
- Ao coarctation (narrowing of descending Aorta)

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15
Q

Pressure Stages of systemic HTN

A
  • NL: < 120/80 mmhg
  • Elevated: systolic between 120-129 and diastolic >80
  • Stage 1: systolic 130-139 and diastolic 80-89
  • stage 2: systolic >140 and diastolic >90
    -HTN crisis: systolic >180 and diastolic >120
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16
Q

What causes the first and second heart sound

A

1st sound: AV valves closing
2nd sound: SL valves closing

17
Q

Role of echo identifying abnormalities caused by systemic HTN

A

1) Determine if there’s left ventricular hypertrophy
2) assess LV systolic and diastolic fxn
3) measure aorta for dilation

18
Q

What are the normal and abnormal values for LV wall thickness

A

Men: 0.6-1.0, 1.1-1.3, 1.4-1.6, >1.6
Women: 0.6-0.9, 1.0-1.2, 1.3-1.5, >1.5

19
Q

What are the normal and abnormal values of left ventricular mass

A

Men: 88-224, 225-258, 259-292, >292
Women: 67-162, 163-186, 187-210, >210

20
Q

Normal values relative wall thickeness

A

Men: 0.24-0.42
Women: 0.22-0.42

21
Q

Equation for Lv wall thickness and mass comparison

A

(IVS+PW)/LVIDd

22
Q

What is the formula for estimation RVSP

A

RVSP=4(Vtr)^2+RAP

23
Q

Values for grading severity in PHTN (PA Pressure)

A

Normal: 18-25mmhg
Mild: 35-45mmhg
Moderate: 45-60mmhg
Severe: > 60mmhg

24
Q

Equation for severity of PHTN when TR is present

A

TRvmax + CVP = PAP

25
Q

Echo findings in significant PHTN

A
  • increased RVSP
  • RVE/RAE/PA dilation
  • septal flattening in Psax (D shaped)
  • TR (dependent on PASP and TR severity)
  • PR (dependent on PA dilation and PASP)
  • dilated IVC with less than 50% collapse
26
Q

Abnormal Values for aorta dilation

A

Root: >3.7cm
Ascending aorta: >4cm

27
Q

What are the values to determine concentric remodeling

A

If RWT is > 0.42 and LV mass < 95 in women and < 115 in men

28
Q

What are the values to determine if Lv wall thickness and mass have normal geometry

A

If RWT is <0.42 and LV mass is <95 in F and <115 in M

29
Q

What are the values to determine if Lv wall thickness and mass have concentric hypertrophy

A

If RWT is >0.42 and LV mass is > 95 in F and > 115 in M

30
Q

What are the values to determine if Lv wall thickness and mass have eccentric hypertrophy

A

If RWT is <.42 and > 95 in F and > 115 in M

Echo Lecture (2 decks)

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