pulmonary HTN Flashcards

1
Q

PA systolic pressure of ____ is PH

A

over 25

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2
Q

you should suspect PH in pt with ____ and ___

A

increasing dyspnea & a known cause

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3
Q

2 complications of PH

A

cor pulmonale and Right HF

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4
Q

prognosis of PH

A

if untreated, 2.8 yrs after diagnosis

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5
Q

4 sx of severe PH

A
  • exertional chest pain
  • exertional syncope
  • peripheral edema
  • anorexia

and known disease

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6
Q

4 exam findings of PH

A
  • Narrowed 2nd heart sounds
  • JV pulse
  • RV failure
  • Cor pulmonale
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7
Q

1st step in work-up, used to screen for PH

A

echo

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8
Q

what’s next if echo is positive vs negative?

A
  • +, do definitive test
  • -, r/o other causes of dyspnea or still do definitive test
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9
Q

definitive diagnostic study for PH

A

right heart catheterization

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10
Q

3 things R heart cath. can tell you

A
  • severity
  • if its R or L sided heart dz
  • congenital or L to R shunt
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11
Q

run through 4 functional classes of PH

A
  1. PH only
  2. PH w/ slight limitations
  3. PH w/ markedly limited physical activity
  4. PH and can’t do anything w/o sx
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12
Q

if someone has PH and exertional sx, what class are they?

A

2

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13
Q

if someone has PH with mild resting sx and undue sx w/ any exertion, what class are they?

A

3

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14
Q

if someone has PH w/ RH failure & increased dyspnea at rest, what class are they?

A

4

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15
Q

for what functional classes do you consider advanced therapy

A

class 2-4

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16
Q

5 primary tx for PH

A
  • diuretics
  • O2
  • anticoag- d/t increased risk for thrombosis from RAE
  • exercise
  • flu & pneumo vaccine
17
Q

palliative measure to shunt left PA blood to descending aorta

A

Transcatheter potts shunt

18
Q

final option for treating PH if all else fails

A

heart transplant

19
Q

which medication works well in vasoreactive pts, causing PA vasodilation

A

CCB– diltiazem, amlodipine

20
Q

1st line in severe dz; inhibits platelet activation & effective vasodilator; improves survival & exercise capacity

A

Prostanoids– Epoprostenol & Treprostinil

21
Q
  • improved pulmonary hemodynamics and exercise capacity
  • MOA: smooth muscle relaxation & PA vasodilation
  • when used with prostanoids, shows improved outcome
A

Sildenafil (PDE5)

22
Q

what two meds improve exercise capacity

A

prostanoids
sildenafil