Pulmonary Hypertension

Question 1

What is pulmonary hypertension?

Answer 1

sustained increase in pressure in the pulmonary circuit above 25 mmHg

Question 2

What is normal pressure in the pulmonary circuit?

Answer 2

15 mmHg

Question 3

What are some characteristics of the pulmonary circuit?

Answer 3

• it is a low pressure, low-resistance circuit
• if cardiac output increases, there is a minimal increase in pulmonary pressure
• pulmonary vasoconstriction causes an increase in pressure

Question 4

What causes pulmonary hypertension?

Answer 4

• can be secondary to cardiac or pulmonary problems

3 categories:

1) an increase in pulmonary volume (can occur with cardiac septal defects)
2) hypoxemia (the lungs react to hypoxemia by vasoconstriction)
3) increase in pulmonary venous pressure (ex. congestion from left-sided heart failure, left ventricular dysfunction)

Question 5

What are the manifestations of pulmonary hypertension?

Answer 5

• dyspnea
• syncope
• chest pain on exertion
• those of right-sided heart failure
• distension of the pulmonary artery and right ventricular hypertrophy seen on chest x-ray

Question 6

How is pulmonary hypertension treated?

Answer 6

• treat the cause if it is reversible
• vasodilators (but will act systemically too)
• decrease in prognosis if severe