Cardio - Pulmonary Hypertension Flashcards Preview

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Flashcards in Cardio - Pulmonary Hypertension Deck (41)
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1

What is the normal PA pressure?

25 mmHg (systole)

2

What is considered PHT?

>30 mmHg (systole)

3

What is mild PHT?

30-50 mmHg

4

What is moderate PHT?

50-75 mmHg

5

What is severe PHT?

>75 mmHg

6

The lungs are _____ pressure, _____ resistance, _____ capacitance.

low, low, high

7

Which side of the heart is at a lower pressure than the other?

R side is much lower pressure than the L

8

What are the 4 causes of PHT?

  1. Idiopathic/primary
  2. L-sided heart disease (MVDz, DCM)
  3. Chronic pulmonary disease (bronchitis, pulm fibrosis)
  4. Pulmonary thromboembolic disease

9

What causes idiopathic/primary PHT?

Retention of fetal PVR

10

What does L-sided heart disease lead to in terms of PHT?

pulm venous hypertension

11

What does chronic pulmonary disease lead to in terms of PHT?

Hypoxemia and vasoconstriction

12

What are some pulmonary thromboembolic diseases?

HWD, PLN, PLE, Cushings

13

What side of the heart has precapillary PHT?

R side

14

What side of the heart has post-capillary PHT?

Left 

15

What is pre-capillary PHT?

Disease before the blood reaches the capillaries

16

What is post-capillary PHT?

High pressure after the capillaries that backed up across the capillary bed

17

All PHT causes are ____-capillary EXCEPT _____.

pre, L-sided heart disease

18

What happens to the pulmonary arteries/arterioles in PHT?

Medial hypertrophy of tunica media, intimal proliferation and fibrosis, plexiform lesions

19

What happens to the heart in PHT?

High RV afterload --> RV hypertrophy/dilation --> MPA enlargement --> tricuspid regurg --> pulmonic regurg --> IVS flattening/small LV

20

PHT occurs due to too much _____.

afterload

21

What are the CS associated with PHT?

Syncope, dyspnea, exercise intolerance cough (from underlying lung disease)

22

PHT is often misdiagnosed as _____ secondary to _____.

L-CHF, MVDz

23

How can PHT be differentiated from L-CHF secondary to MVDz?

PHT primarily presents with syncope and exercise intolerance (MVDz is dyspnea and cough)

There is none or a SOFT murmur, R > L (LOUD murmur in MVDz)

Sinus arrhythmia or bradycardia (tachycardia in MVDz)

RV enlargement (vs. LA), pulm artery distention (vs. pulm veins)

24

What are some lateral radiographic findings that can point to PHT?

Lack of LA enlargement, apex of heart not touching sternum (due to RV enlargement pushing it up), enlargement of cranial lobar pulm artery

25

What are some VD radiographic findings that can point to PHT?

Bulge on MPA, generalized interstitial pattern (can be due to heartworm pneumonitis)

26

Doppler echo measures _____ of blood flow.

velocity

27

Velocity of blood flow is determined by _____ _____.

pressure gradient

28

What is the modifed bernoulli equation?

PG = 4v2

29

We can estimate PA pressure using velocity of what two things?

Tricuspid regurg (systolic) or pulmonic regurg (diastolic)

30

How is PHT estimated echocardiographically?

High velocity of tricuspid regurg --> high RV systolic P --> high PA systolic P

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