Pulmonary hypertension

Question 1

What is pulmonary hypertension

Answer 1

defined as mean pulmonary artery pressure >20mmHg at rest

Question 2

How can you classify pulmonary hypertension

Answer 2

5 groups based on underlying aetiology

group 1 - pulmonary arterial hypertension

group 2 - left heart disease

group 3 - lung disease/hypoxia

group 4 - chronic thromboembolic pulmonary hypertension

group 5 - miscellaneous

Question 3

What is pulmonary arterial hypertension

Answer 3

subtype of pulmonary hypertension

characterised by elevated pulmonary artery pressure, normal capillary wedge pressure and increased pulmonary vascular resistance

can be idiopathic or associated with various conditions

Question 4

What is first line investigation

Answer 4

Echocardiography

Question 5

What is gold standard investigation

Answer 5

Right heart catheterisation

Question 6

What are some other investigations

Answer 6

Pulmonary function tests
arterial blood gas analysis
CXR
CT pulmonary angiography

Question 7

How are patients with PAH trested

Answer 7

targeted pulmonary vasodilator therapy
- prostacyclin analogues
-endothelin receptor antagonists
BOSENTAN ,AMBRISENTAN

• phosphodiesterase type 5 inhibitors
  SILDENAFIL and TADALAFIL

Question 8

What are other treatment options

Answer 8

oxygen therapy
diuretics
anti-coagulation

lung transplant in severe cases