Term
| Pulmonary HTN is a progressive increase in __ __ __ __ of greater than __ at rest or __ during exercise. |
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Definition
- mean Pulmonary Artery Pressure (PAP)
- greater than 25 at rest
- 30 during exercise |
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Term
| With Pulmonary HTN, the pulmonary arteries ___ and there is increased pulmonary blood pressure greater than __ . |
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Definition
- vasoconstrict
- greater than 30 mmHg |
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Term
| How do you measure pulmonary blood pressure? |
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Definition
| right heart catheterization |
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Term
| Primary Pulmonary HTN is rare. More common in __ ages __ to __ y/o. There is a ___ tendency. Usually die withing __ years of dx. |
|
Definition
- females ages 20-40
- hereditary
- 5 years |
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Term
| With Secondary Pulmonary HTN, there is existing __ or ___ disease such as __ __ __, ___, __ __, or __ __ . |
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Definition
- mitral valve disease
- COPD
- Heart Disease
- Liver Disease |
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Term
| Manifestations of pulmonary HTN without right heart failure: |
|
Definition
- not evident until late in progression
- dyspnea and fatigue that worsens over time
- cyanosis and tachycardia
- crackles
- decreased breath sounds |
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Term
| Pulmonary HTN causes __ __. |
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Definition
|
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Term
| Tricuspid regurg causes big bounding ___ b/c when right ventricle contracts fluid is going back up to vena cava. |
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Definition
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Term
| Symptoms of pulmonary HTN: |
|
Definition
- dyspnea
- fatigue
- lightheadedness
- syncope
- angina |
|
|
Term
|
Definition
- JVD
- loud P2
- Tricuspid Regurg murmur
- Parasternal shift
- CLEAR LUNGS |
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Term
| With pulmonary HTN, there is __ RV afterload, ___ EDV, __ EF, and __ SV of the RV. |
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Definition
- increased RV afterload
- increased EDV
- decreased EF
- decreased |
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Term
| Chronic pulmonary HTN leads to a progressive systolic pressure overload of the ___, resulting in __ __ and __ and gradual __ dysfunction. |
|
Definition
- RV
- RV dilation and hypertrophy
- RV dysfunction |
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Term
| Collagen vascular diseases that may result in pulmonary arterial HTN: |
|
Definition
- scleroderma
- lupus
- rheumatoid arthritis |
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Term
| HIV, drugs, toxins can result in pulmonary HTN |
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Definition
|
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Term
| Pulmonary HTN may be associated with diseases of the respiratory system and/or hypoxemia such as: |
|
Definition
- Parenchymal lung diseases (COPD, interstitial pulmonary fibrosis, CF)
- Chronic Alveolar Hypoxemia (exposure to long term low oxygen tension like high altitude) |
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Term
| Causes of pulmonary venous HTN: |
|
Definition
- Mitral valve disease
- Chronic LV dysfunction
- Pulmo venooclusion disease |
|
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Term
| Pulmonary HTN can be due chronic thrombotic/embolic disease such as __ __ of the __ __ __ or __ of the __ __ __ |
|
Definition
- thromboemoblic obstruction of proximal pulmonary arteries
- obstruction of distal pulmonary arteries |
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|
Term
| Gold standard for dx of pulmonary HTN: |
|
Definition
| Right Heart Catheterization |
|
|
Term
| Info from a Right Heart Cath: |
|
Definition
- RA and RV pressures
- pulmonary artery pressure (mean PAP>25 at rest or >30 with exercise)
- Capillary wedge pressure
- Cardiac output
- Calculated pulmonary vascular resistance
- Prognostic (RAP, CI, mPAP)
- Response to vasodilator challenge |
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|
Term
| CO from right side of heart = CO from left side of heart |
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Definition
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Term
| Other methods besides right heart cath for dx of pulmonary htn? |
|
Definition
- 2nd choice: Echocardiogram- estimates pulmonary artery pressures, looks for shunts and valvular disease, ventricular function
- CXR- enlarged proximal pulmonary vessels, distal "pruning"
- ECG: RAD, RAE, RVH most common |
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Term
| X-ray manifestations of pulmonary HTN: |
|
Definition
- enlarged proximal pulmonary vessels
- distal pruning |
|
|
Term
| EKG manifestations of pulmonary HTN: |
|
Definition
- right axis deviation
- right atrial enlargement
- right ventricular hypertrophy |
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Term
| Pulmonary function tests are useful for distinguishing b/w __ and __ __ __. |
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Definition
| - obstructive and restrictive lung disease |
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Term
| __ __ __ are good for identifying interstial lung disease |
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Definition
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Term
| VQ scan and CT angiogram can rule out __ __ |
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Definition
|
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Term
|
Definition
- Treat underlyinig cause
- Tobacco cessation
- Supplemental oxygen
- Anticoagulation
- Vasodilation- Saldenafil, Vardenafil (PDE-5 inhibitors are used in lower doses for pulmonary HTN) |
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|
Term
| what type of vasodilators are used for the tmt of pulmonary HTN? |
|
Definition
| - PDE-5 inhibitors (-afils) |
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