Pulmonary Hypertension

Question 1

Definition of pulmonary hypertension

Answer 1

Increase in mean pulmonary arterial pressure (15ml/g) which is associated with number of conditions

Question 2

Features of pulmonary hypertension

Answer 2

SOb, fatigue, syncope, raised JVP, parasternal heave, loud P2, presence of S3 sound, pansystolic murmur and end-diastolic murmur

Question 3

Parenchymal lung disease causes

Answer 3

COPD, asthma, ILD, bronchiectasis, CF

Question 4

pulmonary vascular disease causes

Answer 4

Idiopathic pulmonary hypertension, pulmonary vasculitis, PE, portal hypertension

Question 5

Hyperventilation causes of pulmonary hypertension

Answer 5

Sleep apnoea, kyphosis, scoliosis, NMJ conditions (myasthenia gravis)

Question 6

Heart diseases which can cause pulmonary hypertension

Answer 6

mitral stenosis, mitral regurgitation, LVF

Question 7

ECG findings in pulmonary hypertension

Answer 7

P pulmonale, RBH, right axis deviation

Question 8

Investigations into pulmonary hypertension

Answer 8

ECHO, right heart catheterisation which shows mean pulmonary arterial pressure of >25mmHg

Question 9

Management of pulmonary hypertension

Answer 9

Treat underlying condition, reduction of pulmonary vascular resistance, manage HF, heart-lung transplant for selected cases

Question 10

How to reduce pulmonary vascular resistance

Answer 10

LTOT, Nifedipine, sildenafil, prostacycline analogues, Bosentan

Question 11

Causes of pulmonary oedema

Answer 11

CAD, cardiomyopathy, heart valve problems, HTN, myocarditis, arrhythmias, renal artery stenosis, amyloidosis, thyroid disease

Question 12

Causes of non-cardiogenic pulmonary oedema

Answer 12

ARDS, drug reaction or overdose, PE, certain toxins, high altitudes, neurogenic, smoke inhalation, infections