Pulmonary Hypertension

Question 1

What is Pulmonary Hypertension?

Answer 1

↑pulmonary artery pressure due to various causes

Includes pulmonary vascular disease, pulmonary parenchymal disease, and increased left heart filling pressure.

Question 2

List the causes of Pulmonary Hypertension.

Answer 2

• PAH: idiopathic, hereditary, collagen vascular diseases, systemic to pulmonary shunts, portal HTN, HIV
• L heart disease: systolic or diastolic dysfunction, valvular disease
• Lung disease/hypoxia: COPD, interstitial lung disease, sleep apnea, chronic hypoventilation
• Chronic pulmonary embolism
• Others: systemic diseases (ie. sarcoidosis), hematologic diseases (ie. myeloproliferative diseases)

Each category includes distinct underlying conditions leading to increased pulmonary artery pressure.

Question 3

What are the symptoms of Pulmonary Hypertension?

Answer 3

• Exertional dyspnea
• Fatigue
• Angina
• Syncope
• Peripheral cyanosis
• Oedema – late findings

Symptoms can vary in severity and may progress over time.

Question 4

What physical exam findings are associated with Pulmonary Hypertension?

Answer 4

• Jugular distension
• Tricuspid regurgitation

These findings can indicate right heart strain and fluid overload.

Question 5

What does a CXR reveal in cases of Pulmonary Hypertension?

Answer 5

Enlarged pulmonary artery

This radiographic finding is indicative of elevated pulmonary artery pressure.

Question 6

What ECG changes may be seen in Pulmonary Hypertension?

Answer 6

Right ventricular hypertrophy

This change reflects the strain on the right ventricle due to increased pressure.

Question 7

What is the standard treatment for Pulmonary Hypertension?

Answer 7

• Limit physical activity
• Diuretics
• Oxygen supplementation
• Chronic warfarin anticoagulation

These treatments aim to manage symptoms and improve quality of life.

Question 8

Name some additional treatments for Pulmonary Hypertension.

Answer 8

• Endothelin receptor antagonists (Bosentan)
• PDE5 inhibitors (sildenafil, tadalafil)
• Prostaglandins
• Lung transplant in patients with persistent right heart failure

These treatments target the underlying mechanisms of pulmonary hypertension.

Question 9

Fill in the blank: The primary symptom of Pulmonary Hypertension is _______.

Answer 9

exertional dyspnea

Question 10

True or False: Systemic diseases can contribute to Pulmonary Hypertension.

Answer 10

True

Conditions like sarcoidosis can lead to elevated pulmonary artery pressure.