Pulmonary Hypertension Flashcards
What is pulmonary hypertension?
Increased resistance and blood pressure in the pulmonary arteries.
Mean pulmonary arterial pressure >25mmHg.
What is normal mean pulmonary artery pressure?
15mmHg.
What are the causes of pulmonary hypertension?
Connective tissue disorders - SLE Left heart failure - MI, systemic hypertension, mitral stenosis, mitral regurgitation Lung disease - COPD PE Sarcoidosis Idiopathic Asthma
What are the signs and symptoms of pulmonary hypertension?
SOB Syncope Tachycardia Raised JVP (INCREASED SYSTEMIC VENOUS PRESSURE) hepatomegally peripheral oedema
What signs does an ECG show?
Large R waves - on V1,2,3.
Large S waves - on V4,5,6.
Right axis deviation
Right bundle branch block
What does a chest X-ray show?
Dilated blood vessels
Right ventricular hypertrophy
When is BNP high?
Brain natriuretic peptide is made by the heart and blood vessels - Increased in heart failure. Increased in pulmonary hypertension.
Why is an ECHO done?
To estimate pulmonary artery pressure
What is the prognosis?
30-40% 5-year survival.
What is the treatment of primary pulmonary hypertension?
IV prostaglandins (epoprostanol) Endothelial receptor antagonists (Bosentan) Phosphodiesterase-5 inhibitors (sildenafil)
What is the gold standard investigation?
Right sided heart catheterisation - shows mean pulmonary artery pressure >25mmHg.
What is the treatment for secondary pulmonary hypertension?
Treat the secondary cause.
