Portal Hypertension Flashcards
Most common cause if portal hypertension is
Liver cirrhosis
Portal venous system comprises of
Portal vein
mesenteric vein
Splenic vein
which leads to hypoxic pulmonary vasoconstriction. Severe and long-standing OSA causes a constant increase in pulmonary pressure, which can result in right ventricular dysfunction known as?
Obstructive sleep apnea
Confirmatory test to identify pulmonary hypertension
RT heart cateterization to identify pulmonary hypertension
Five causes of pulmonary hypertension
1) idiopathic or hereditary, (2) left-sided heart disease, (3) chronic hypoxic lung disease, (4) chronic thromboembolism (CTEPH), and (5) unclear multifactorial mechanisms.
Accentuated s2 shows
Pulmonary hypertension
Pressure rise in portal hypertension?
5-10 mmhg
Most common cause of upper go bleeding is
Portal hypertension
Complications of portal hypertension
Hemorrhoids
Caput meddosa
Splenomegaly(anemia leukopenia thrombocytopenia)
Release nitric oxide which causes hypotension
SBP
Ascitis
ABCD for portal hypertension stands for
Ascitis
Bleeding
Caput medossa
Diminished liver function
Enlarged spleen
Causes of portal hypertension
Prehepatic thrombus in the portal vein
Intra hepatic schistoconiasis CLD sarcoidosis
Post hepatic rat sided heart failure and budd chiary syndrome (tumor or thrombus obstructs blood flow inside inferior vena cava)
Gold standard diagnosis for portal hypertension is
Hepatic venous pressure gradient measurement
Management of portal hypertension
Propanolol
Esophageal varices mgt
Octrotida
Sclerotherapy
Variceal ligation ballon temponade
Tipss procedure to decrease hepatoportalpressure
Indication for TIPS is
Recurrent variceal bleeding
Adverse out come of tips includes
Following TIPS placement, patients are at increased risk of developing hepatic encephalopathy because blood now bypasses the liver, reducing the elimination of ammonia
