Pulmonary hypertension and thromboembolism Flashcards Preview

Year 2 Respiratory > Pulmonary hypertension and thromboembolism > Flashcards

Flashcards in Pulmonary hypertension and thromboembolism Deck (31)
1

what is an SQT133 pattern? what does it suggest?

deep S wave in lead I
Q wave in III
inverted T wave in III

this “classic” finding is neither sensitive nor specific for pulmonary embolism; found in only 20% of patients with PE

2

what is the primary imaging study for PE?

CT pulmonary angiography

3

what is the gold standard study for PE diagnosis?

pulmonary angiography

4

what is the primary therapy for all PE cases?

STAT anticoagulation

5

what is used for massive PE with hemodynamic compromise?

thrombolytic therapy (TPA)

6

what are indications for an IVC filter?

proximal DVT
absolute contraindication to anticoagulation

7

when are calcium channel blockers used in PHTN?

small % of WHO group 1 patients with a positive response to vasodilator challenge

8

PH treatment for WHO group 2

treat left sided heart disease

9

PH treatment for WHO group 4

pulmonary thromboendarterectomy

10

is PA pressure a target of therapeutic strategy?

no

11

when should WHO group 1 PHTN considered?

1. evidence of right HF
2. dyspnea on exertion out of proportion (particularly young women)
3. high risk groups and family history
4. CT disease - SCLERODERMA

12

what is the role of echo in PHTN?

good screening test but does not definitively diagnose or rule out

13

what is needed for diagnosis and to guide therapy for PHTN?

RHC with vasodilator testing

14

who are the only candidates for PHTN specific therapies?

WHO group 1 patients

15

what is the most important prognostic marker in patients with group 1 PHTN?

RV function

16

when is lung transplant indicated?

medically refractory patients

17

most PHTN patients are in which class?

WHO group 2 - pulmonary venous HTN

18

definition of PHTN

mean pulmonary arterial pressure derived from right heart catheterization equal to or more than 25 mm Hg

19

what is normal mean pulmonary arterial pressure?

8-20 mm Hg

20

WHO group 1 PHTN

pulmonary arterial HTN (precapillary PHTN)

21

WHO group 2 PHTN

pulmonary venous HTN from left sided heart disease (postcapillary PHTN)

22

WHO group 3 PHTN

PHTN from lung disease and/or hypoxia

23

WHO group 4 PHTN

chronic thromboembolic PHTN

24

WHO group 5 PHTN

PHTN with unclear multifactorial mechanisms

25

PHTN from lung disease and/or hypoxia

WHO group 3 PHTN

26

pulmonary venous HTN from left sided heart disease (postcapillary PHTN)

WHO group 2 PHTN

27

PHTN with unclear multifactorial mechanisms

WHO group 5 PHTN

28

pulmonary arterial HTN (precapillary PHTN)

WHO group 1 PHTN

29

chronic thromboembolic PHTN

WHO group 4 PHTN

30

how is a definitive diagnosis of PHTN made?

right heart catheterization

31

what differentiates WHO group 1 from WHO group 2?

group 1 has normal wedge pressures (normal left heart pressures) - precapillary pulmonary artery HTN

group 2 has wedge pressures over 15 mm Hg - post-capillary pulmonary venous HTN from left sided heart disease