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Pulmonary HTN Exam 1
Pulmonary HTN Exam 1
28
Anatomy
Graduate
11/15/2011

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Term
Pulmonary HTN is a progressive increase in __ __ __ __ of greater than __ at rest or __ during exercise.
Definition
- mean Pulmonary Artery Pressure (PAP)
- greater than 25 at rest
- 30 during exercise
Term
With Pulmonary HTN, the pulmonary arteries ___ and there is increased pulmonary blood pressure greater than __ .
Definition
- vasoconstrict
- greater than 30 mmHg
Term
How do you measure pulmonary blood pressure?
Definition
right heart catheterization
Term
Primary Pulmonary HTN is rare. More common in __ ages __ to __ y/o. There is a ___ tendency. Usually die withing __ years of dx.
Definition
- females ages 20-40
- hereditary
- 5 years
Term
With Secondary Pulmonary HTN, there is existing __ or ___ disease such as __ __ __, ___, __ __, or __ __ .
Definition
- mitral valve disease
- COPD
- Heart Disease
- Liver Disease
Term
Manifestations of pulmonary HTN without right heart failure:
Definition
- not evident until late in progression
- dyspnea and fatigue that worsens over time
- cyanosis and tachycardia
- crackles
- decreased breath sounds
Term
Pulmonary HTN causes __ __.
Definition
paradoxial splitting
Term
Tricuspid regurg causes big bounding ___ b/c when right ventricle contracts fluid is going back up to vena cava.
Definition
JVD
Term
Symptoms of pulmonary HTN:
Definition
- dyspnea
- fatigue
- lightheadedness
- syncope
- angina
Term
Signs of Pulmonary HTN:
Definition
- JVD
- loud P2
- Tricuspid Regurg murmur
- Parasternal shift
- CLEAR LUNGS
Term
With pulmonary HTN, there is __ RV afterload, ___ EDV, __ EF, and __ SV of the RV.
Definition
- increased RV afterload
- increased EDV
- decreased EF
- decreased
Term
Chronic pulmonary HTN leads to a progressive systolic pressure overload of the ___, resulting in __ __ and __ and gradual __ dysfunction.
Definition
- RV
- RV dilation and hypertrophy
- RV dysfunction
Term
Collagen vascular diseases that may result in pulmonary arterial HTN:
Definition
- scleroderma
- lupus
- rheumatoid arthritis
Term
HIV, drugs, toxins can result in pulmonary HTN
Definition
Term
Pulmonary HTN may be associated with diseases of the respiratory system and/or hypoxemia such as:
Definition
- Parenchymal lung diseases (COPD, interstitial pulmonary fibrosis, CF)
- Chronic Alveolar Hypoxemia (exposure to long term low oxygen tension like high altitude)
Term
Causes of pulmonary venous HTN:
Definition
- Mitral valve disease
- Chronic LV dysfunction
- Pulmo venooclusion disease
Term
Pulmonary HTN can be due chronic thrombotic/embolic disease such as __ __ of the __ __ __ or __ of the __ __ __
Definition
- thromboemoblic obstruction of proximal pulmonary arteries
- obstruction of distal pulmonary arteries
Term
Gold standard for dx of pulmonary HTN:
Definition
Right Heart Catheterization
Term
Info from a Right Heart Cath:
Definition
- RA and RV pressures
- pulmonary artery pressure (mean PAP>25 at rest or >30 with exercise)
- Capillary wedge pressure
- Cardiac output
- Calculated pulmonary vascular resistance
- Prognostic (RAP, CI, mPAP)
- Response to vasodilator challenge
Term
CO from right side of heart = CO from left side of heart
Definition
Term
Other methods besides right heart cath for dx of pulmonary htn?
Definition
- 2nd choice: Echocardiogram- estimates pulmonary artery pressures, looks for shunts and valvular disease, ventricular function
- CXR- enlarged proximal pulmonary vessels, distal "pruning"
- ECG: RAD, RAE, RVH most common
Term
X-ray manifestations of pulmonary HTN:
Definition
- enlarged proximal pulmonary vessels
- distal pruning
Term
EKG manifestations of pulmonary HTN:
Definition
- right axis deviation
- right atrial enlargement
- right ventricular hypertrophy
Term
Pulmonary function tests are useful for distinguishing b/w __ and __ __ __.
Definition
- obstructive and restrictive lung disease
Term
__ __ __ are good for identifying interstial lung disease
Definition
High Resolution CTs
Term
VQ scan and CT angiogram can rule out __ __
Definition
chronic PE
Term
Pulmonary HTN tmt:
Definition
- Treat underlyinig cause
- Tobacco cessation
- Supplemental oxygen
- Anticoagulation
- Vasodilation- Saldenafil, Vardenafil (PDE-5 inhibitors are used in lower doses for pulmonary HTN)
Term
what type of vasodilators are used for the tmt of pulmonary HTN?
Definition
- PDE-5 inhibitors (-afils)
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