Respiratory - Pulmonary Hypertension + PTE Flashcards
Pulmonary hypertension (PH) refers to
elevated pulmonary arterial pressure
Systolic PAP >30mmHg
Mean PAP > 20mmHg
Diastolic PAP >15mmHg
Under normal conditions, pulmonary circulation has very low ____ and_____ compared to systemic circulation
resistance and pressure
PAP calculation
PAP = (cardiac output x pulmonary vascular resistance) + pulmonary venous pressure
where PVR = (vessel length x viscosity of blood)/radius^4
T/F pulmonary vascular resistance is heavily reliant on the radius of the vessel
true (think, its ^4!)
Classifications of PH
PH due to pulmonary vascular disease PH due to left sided heart disease PH due to chronic pulmonary disease and/or hypoxia PH due to thrombotic or embolic disease miscelaneous
T/F: PH is usually secondary to another condition
true
Signalment for PH
dogs»_space; cats
middle aged to older
small breed > large breeds
Which of the following is not a clinical sign of pulmonary hypertension?
A) cough
B) exertion induced presyncope or syncope
C) tachypnea and dyspnea
D) left sided heart failure
D - right sided heart failure
patients with severe PH may have systemic
hypotension
A murmur due to _______ may be present
tricuspid regurgitation (PMI right apex)
The current non-invasive gold standard test for diagnosis of pulmonary hypertension in small animals is: A) thoracic radiographs B) Ultrasound C) echocardiography D) blood test
C - blood test
A dog comes in presenting with tachypnea, dyspnea, and a cough. The owner mentions the dog has not been able to handle their daily walks and gets tired easily lately. You conduct an echocardiogram and confirm the dog has pulmonary hypertension. What is your next step?
Do a minimum database, a heart worm test, and thoracic radiographs to determine an underlying cause of the pulmonary hypertension
What do you expect to see on a thoracic radio graph of a dog with pulmonary hypertension
A) bronchi that are deviated outwards on a VD view due to enlarged LA
B) ventral deviation of trachea
C) right side enlargement
D) decreased sternal contact of the heart
C - you’d see right side enlargement, cardiomegaly, dorsal deviation of treatment, increased sternal contact, and bronchi would not be deviated away from each other on VD because L side would not be enlarged
T/F: an echo is useful in diagnosing pulmonary hypertension but is limited in what it can tell us about the disease
False, shows us:
tricuspid regurgitation +/- pulmonic regurgitation - can provide estimate of pulmonary pressure
right ventricular hypertrophy and dilation - RV systolic dysfunction is not common but can occur
right atrial dilation, hypertrophy of RV ( tells us pressure overload likely due to pulmonary valve or hypertension)
diastolic flattening of ventricular septum
dilated main pulmonary artery and branches
Modified Bernoulli equation
PG = 4 x velocity^2
