Pulmonary HTN Flashcards
What is Cor Pulmonale
Right sided heart failure due to chronic pulmonary disease
*If left sided HF was present first -> NOT cor pulmonale
What causes acute and chronic cor pulmonale
pulmonary embolism (acute)
COPD (Chronic)
What sx will a patient with cor pulmonale have
peripheral edema
kidney damage (look for proteinuria)
Ascites
Splenomegaly
plethora
CO2 retention
What is plethora
increased RBCs to optimize oxygenations
What amount of fluid accumulation is concerning
increase of 2lbs in 24 hours
What type of cor pulmonale is more common
Secondary (originates as lung or blood vessel disease)
What does hypertrophic muscularis cause
intimal fibrosis
*Smooth muscle hypertrophy occurs and there is proliferation of the vessel intima
Why does the body cause fibrosis to occur
to try to protect the vessel from bursting from the increase pressure
What are symptoms of cor pulmonale
SOB with exertion
Syncope w/ exertion (severe only)
What is the gold standard for diagnosing cor pulmonale
cardiac cath
mean pulmonary pressure >20mmHg
PA wedge >15mmHg
What will be seen on CXR with cor pulmonale
congestion in PA
What causes primary pulmonary HTN
defect of BMPR2 gene
*normally this gene inhibits muscle growth in bronchioles
What causes secondary pulmonary HTN
Destruction of pulmonary artery tree
*COPD,OSA,PE,HTN
What are the classifications of pulmonary HTN
1) PAH
2) PAH from left sided heart disease
3) PAH from lung disease/hypoxia
4) Miscellaneous
What is the treatment for PAH
anticoagulation
PDEi
CA2+ blockers
prostacyclins
endothelial antagonists
