Chapter 9. Pulmonary Heart Disease Flashcards
Pulmonary heart disease is due to what?
- chronic pulmonary HTN
- acute pulmonary emboli
What are the causes of CHRONIC PHTN?
primary: idiopathic - may be genetic
secondary: heart/lung disease
What are the 2D/MMODE findings for chronic PHTN?
- concentric RVH
- PSM and D shaped LV in systole and diastole
- RAE
- PV M Mode: reduced “a” and mid systolic closure
- eventual RV systolic dysfunction
- eventual RVE
- enlarged PA, IVC/hepatics, coronary sinus
What are the DOPPLER findings for chronic PHTN?
- significant TR and PI
- elevated pulmonary pressures
- midsystolic deceleration of pulmonic flow and short PAC
- elevated pulmonary vascular resistance
What does “COR PULMONALE” mean?
term for right sided failure brought on by chronic PHT
Name symptoms that a patient may have with COR PULMONALE
- chest discomfort
- SOB
- DOE
- edema
- cough
- PND
What causes ACUTE PULMONARY EMBOLI?
sudden onset of elevated pulmonary vascular resistance as vein thrombus travels and lodges in the distal branches of the PA
What are the SIGNS of acute pulmonary emboli?
- Immediate RVD and RV systolic dysfunction
- significantly elevated pulmonary pressure and resistance
- dagger shaped TR
What is the MCCONNELL SIGN?
RV free wall hypokinesis with normal apical contraction
What are the SYMPTOMS of acute pulmonary emboli?
- SOB
- sharp chest pain that is worse with deep breath
- cough with possible hemoptysis
- rapid HR
- sweating
- cyanosis
What are the TREATMENTS for acute pulmonary emboli?
- anticoagulation
- surgical or catheter embolectomy (if pt has several or large clot)
- IVC filters for chronic pulmonary embolic
When is ECMO therapy used?
in patients with respiratory distress due to lung disease
