Pulmonary Hypertension

Question 1

pulmonary hypertension

Answer 1

localized HTN in the pulmonary circuit w/ a sustained pulmonary arterial pressure of >25mmHg

Question 2

etiology

Answer 2

• can be r/t to cardiac and/or pulmonary issues
• inc pulmonary vol
• inc pulmonary venous pressure
• inc in pressure d/t pulmonary vasoconstriction

Question 3

inc pulmonary vol example

Answer 3

cardiac septal defects –> blood in L vent leaks back into R vent through hole in the interventricular septum that did not close during embryogenesis –> results in inc vol of blood to travel through pulmonary circuit

Question 4

inc pulmonary venous pressure example

Answer 4

L vent dysfx –> congestion of blood in the pulmonary vein

Question 5

patho

Answer 5

Hypoxemia –> hypoxia in lungs & hypercapnia in blood –> compensatory vasoconstriction occurs to prevent spread of inc CO2 throughout the body –> inc pressure within pulmonary circuit

Question 6

mnfts

Answer 6

• dyspnea
• syncope (LOC)
• chest pain upon exertion (inc RR = inc demand)
• fatigue
• mnfts of R-sided HF
• R vent hypertrophy

Question 7

why do R-sided HF mnft

Answer 7

R vent pumps against resistance d/t inc pressure in pulmonary artery

Question 8

why does R vent hypertrophy mnft

Answer 8

d/t inc workload requiring inc muscle size & distended pulmonary arteries (inc pressure & blood vol = distention)

Question 9

Tx

Answer 9

• based on underlying cause

- vasodilators (1st line of Tx): Ca2+ channel blockers & Prostacyclin

Question 10

prostacyclin

Answer 10

a more potent vasodilator than Ca channel blocker that results in dilation of R vent

• R atrioventricular valve inc Fx to prevent regurgitation to prevent R-sided HF
• also an antithrombotic