Pulmonary Hypertension

Question 1

What does pulmonary hypertension refer to?

Answer 1

Increased resistance and pressure in the pulmonary arteries

This condition causes strain on the right side of the heart as it tries to pump blood through the lungs.

Question 2

What is the mean pulmonary arterial pressure threshold for diagnosing pulmonary hypertension?

Answer 2

> 20 mmHg

Question 3

What are the five groups that classify the aetiology of pulmonary hypertension?

Answer 3

• Idiopathic pulmonary hypertension or connective tissue disease (e.g. SLE)
• Left heart failure (usually due to MI or systemic hypertension)
• Chronic lung disease (e.g. COPD, pulmonary fibrosis)
• Pulmonary vascular disease (e.g. pulmonary embolism)
• Miscellaneous (e.g. sarcoidosis, glycogen storage disease, haematological disorders)

Question 4

What is the main presenting symptom of pulmonary hypertension?

Answer 4

Shortness of breath

Question 5

List two other clinical features of pulmonary hypertension.

Answer 5

• Syncope
• Tachycardia

Question 6

What does raised JVP indicate in pulmonary hypertension?

Answer 6

Back pressure through the right side of the heart

Question 7

What are common ECG findings in pulmonary hypertension?

Answer 7

• P pulmonale (peaked P waves)
• Right ventricular hypertrophy (tall R waves in V1, V2 and deep S waves in V5, V6)
• Right axis deviation
• Right bundle branch block

Question 8

What chest x-ray findings are indicative of pulmonary hypertension?

Answer 8

• Dilated pulmonary arteries
• Right ventricular hypertrophy

Question 9

What laboratory marker is raised in cases of right ventricular failure due to pulmonary hypertension?

Answer 9

NT-proBNP

Question 10

What is the prognosis for idiopathic pulmonary hypertension?

Answer 10

Poor, mean survival 2-3 years

Question 11

Name two treatment options for idiopathic pulmonary hypertension.

Answer 11

• Calcium channel blockers
• IV prostaglandins (e.g. epoprostenol)

Question 12

What is a supportive treatment for pulmonary hypertension?

Answer 12

• Oxygen
• Diuretics

Question 13

True or False: Treating the underlying cause is a management strategy for secondary pulmonary hypertension.

Answer 13

True

Question 14

Fill in the blank: The presence of _______ can indicate right-sided heart strain.

Answer 14

p pulmonale

Question 15

What does raised JVP stand for?

Answer 15

Jugular venous pressure