Condition- Pulmonary Hypertension Flashcards
1
Q
What is pulmonary hypertension and what value of mean Pulmoary Arterial pressure is defined as pulmoary hypertension?
A
- It results in a progressive increase in pulmonary vascular resistance (PVR)
- It is defined by a mean pulmonary arterial pressure ≥25 mmHg at rest
2
Q
List some of the causes of PAH…
A
- Idiopathic
- Hereditary- genetic mutations
- Drug and toxin induced
- Left ventricular failure + Valvar diseases + outflow tract cardiomyopathies
- Lung disease: COPD, Interstitial lung disease
- PE
3
Q
Describe some of the symptoms experienced by a patient with PAH
A
- pregressive SOB esp on exertion
- May have chest pain
- Weakness/ tiredness
- Exertional dizziness/ syncope
- Late stage- oedema and ascites
- Angina and tachyarrhythmia
4
Q
List some of the signs of PAH…
A
5
Q
State a gene mutation which increases the risk of developing PAH
A
Bone morphogenic protein receptor 1 (BMPR2)- changes in intracellular signalling pathways that result in proliferative and anti-apoptotic effects in the pulmonary vasculature
6
Q
Which age group and gender is thought to be more at risk of PAH?
A
20-50 yr olds
Females> Males
7
Q
List some of the signs of PAH upon examination
A
- Cyanosis
- Raised JVP
- Right ventricular heave
- Loud pulmonary second heart sound (P2)- because of delayed closure of pulmonic valve
- MURMUR: High-pitched, holosystolic, best heard at the left sternal border- tricuspid regurgitation
- MURMUR: An early diastolic high-pitched Graham Steell murmur- pulmonic regurgitation
- Peripheral Oedema
- Ascites
8
Q
List some appropriate investigations for someone with PAH
A
- CXR: to exlude other lung diseases
- ECG: right ventricular hypertrophy + strain
- Transthoracic doppler echocardiography: to check systolic pulmonary artery pressure and visualise right atrial and ventricular dilation
- Right Heart Catheterisation: test to confirm PAH. Mean pulmonary arterial pressure >25 mmHg at rest
- PFTs
- LFTs: to exclude portal hypertension
