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Flashcards in Pulmonary HTN DSA Deck (14)
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1
Q

Pulmonary HTN is defined as ________

A

Mean pulmonary arterial pressure of 25mmHg or greater at rest.

2
Q

When PH develops, it can lead to what?

A

Secondary effects on right-sided heart function and patient symptoms

3
Q

What are the etiologies for group 1-group 5 pulmonary HTN?

A
  • Group 1 (PAH) = idiopathic and CT diseases
  • Group 2 = PH secondary to heart (i.e., systolic, diastolic, valvular)
  • Group 3 = PH secondary to lungs
  • Group 4 = PH seconary to pulmonary emboli
  • Group 5 = all others (i.e., hematologic, systemic, metabolic..)
4
Q

80% of PH are due to what?

A
    1. Increase left-sided heart filling pressure (group 2)
    1. Pulmonary disease (group 3)
5
Q

Mangement of idiopathic PAH is different from other causes because treatment is focused on _______.

A

Vasodilators

6
Q

What are the best predictors of prognosis for pulmonary HTN than pulmonary arterial pressure?

A

- Right-sided heart function

AND

  • Functional status (as determined by 6-minute walk test)
7
Q

What are the most common symptoms of pulmonary HTN?

A

1. Fatigue

2. Dyspnea

Other: palpitations, chest pain

8
Q

What are signs of advanced PH?

A

Right ventricular decomposition including:

  1. syncope
  2. edema
  3. ascites
  4. hepatomegaly.
9
Q

Which finding on CXR is suggestive of pulmonary HTN?

A

Pulmonary artery enlargement

10
Q

What is needed to confirm the diagnosis of pulmonary HTN and to assess its cause if therapy is to be considered?

A
  • Right heart catheterization*** and direct measurement of mean pulmonary artery pressure
  • Echocardiography w/ estimated mean systolic pulmonary artery pressure of 40 mmHg or greater is highly suggestive
11
Q

Once PH is confirmed, what is the next step?

A

Eval is directed at determing cause, anatomic involvement and extent of vascular involment.

12
Q

What othe scans can be helpful in selected patients?

A
  1. Imaging of chest to assess parenchymal lung disease
  2. VQ scanning to assess thromboembolic dz
  3. Serologic studies for CT, liver disease or HIV
  4. B-type NP or troponins
13
Q

All patients suspected of having PAH should be considrered for what to confirm diagnosis and guide therapy?

A

Right heart/pulmonary artery catheterization

14
Q

How do we treat pulmonary HTN?

A

Treat underlying condtion