Pulmonary HTN & Cor Pulmonale Flashcards Preview

Clin Med I - Pulmonary > Pulmonary HTN & Cor Pulmonale > Flashcards

Flashcards in Pulmonary HTN & Cor Pulmonale Deck (31):
1

Define pulm HTN (PAH)

- increased pulm a. pressure --> RV hypertrophy --> R side heart failure

2

What does the right ventricle best respond to?

- volume changes/expansion

3

Define Group 1 PAH

- increased pulm a. pressure with normal capillary wedge pressure

4

Define Group 2 PAH

- increased pulm a. pressure & pulm capillary wedge pressure

5

What is also seen in Group 2 PAH?

- left sided atrial or ventricular heart disease
- left sided valvular disease

6

Define Group 3 PAH?

- chronic hypoxia with mild increase of pulm a. pressure

7

Define Group 4 PAH?

- elevated pulm a. pressure with documented pulm a. obstruction for > 3mo

8

Define Group 5 PAH?

- elevated pulm a. pressure in association with systemic disease & unclear mechanism

9

What are the symptoms of PAH?

- dyspnea w/ exertion
- chest pain
- fatigue
- lethargy
- weakness
- syncope

10

What labs should be drawn for PAH and what does it show?

- CBC: polycythemia 2ndary to chronic hypoxia

11

What diagnostic studies should be ordered for PAH?

- CXR
- EKG
- Echo

12

What will a CXR show in PAH?

- enlarged pulmonary a.

13

What will an EKG show in PAH?

- RVH
- right atrial hypertrophy
- RV strain

14

What will an Echo show in PAH?

- ejection fraction

15

What is the 1 definitive diagnostic test for PAH?

- right heart cath

16

What is the treatment for Group 1 PAH?

- Ca+2 channel blockers
- endothelial receptor antagonists
- phosphodiesterase-5 inhibitors
- prostacyclines
- lung transplant

17

What is included in the group of prostacyclines used to treat Group 1 PAH?

- iloprost
- epopprostenol
- preprostinil

18

What is the treatment for Group 2-5 PAH?

- tx underlying dz

19

What is the f/u for PAH?

- q 3mo w/ labs prior to appt

20

Define cor pulmonale

- alteration in the structure & function of the RV caused by a primary disorder of the pulmonary system

21

What causes cor pulmonale?

- MC: PAH

22

What are the symptoms of chronic cor pulmonale related to?

- underlying dz

23

What are the S&S of cor pulmonale?

- dyspnea
- chronic productive cough
- wheezing
- fatigue/weakness
- orthopnea & PND
- LE edema

24

What is seen on PE in cor pulmonale?

- increased JVP
- V wave in JVP
- tachypnea
- RV palpable heave
- decreased ejection fraction
- hepatomegaly
- LE edema
- cyanosis & clubbing

25

What is the gold standard for diagnosing cor pulmonale?

- right heart cath

26

What are the other diagnostic tests for cor pulmonale?

- echo *intitial test*
- CXR
- PFTs
- spirometry & lung volumes
- ABG
- CT
- V/Q scan

27

What will be drawn for labs and what will be seen in cor pulmonale?

- CBC: polycythemia d/t hypoxia
- SaO2 less than or equal to 85%

28

What will be seen on PFTs in cor pulmonale?

- frequently abnormal
- MC: impaired diffusion capacity
- restrictive ventilatory defect

29

What is the treatment for cor pulmonale?

- tx underlying dz
- improve O2 & RV function by increasing RV contractility & decreasing pulmonary vasoconstriction

30

How is cor pulmonale managed?

- salt restriction
- smoking cessation
- vasodilators
- pt educations

31

What are complications of cor pulmonale?

- syncope
- hypoxia
- pedal edema
- passive hepatic congestion
- death