Please enable JavaScript.
Coggle requires JavaScript to display documents.
Pulmonary HTN (Pathophysiology (Arterial HTN
Problem with the arterial…
Pulmonary HTN
Pathophysiology
Arterial HTN
Problem with the arterial vasculature
causing excess blood flow into the lungs
OR problem with the lungs reducing flow
-
Neonates/children
Pressure falls to normal if early correction of
congenital heart disease
If left, irreversible damage to pulmonary vasculature
and irreversible HTN
Diagnosis
Investigations
-
Bloods
FBC, U+E LFT
Virology (HIV)
Immune screen (ANA, ANCA)
Imaging
CXR: may have cardiomegaly, hyperinflation etc.
ECHO: valve/structural heart disease
Angiography: measure HTN in pulmonary vasculature
Examination
Cardio
Murmurs (valve disease, shunts)
Signs of HF (bibasal crackles, ankle oedema)
Resp
Pink/cyanotic (COPD), breathless (COPD, ILD, oedema),
barrel chest (COPD), bibasal crackles (oedema),
widespread fine crackles (ILD)
History
-
-
PC/HPC
Asyptomatic, signs of HF
-
SH
Living arrangements, occupation
Management
Medical
cGMP inhibitors
Indication: delaying transplantation
E.g. inhaled NO, IV Mg, PDE-5 inhibitors e.g. sildenafil
MOA: vasodilatation of pulmonary vasculature, reducing HTN
Anticoagulation
Indication: reduce VTE risk
E.g. aspirin, heparin, warfarin
-
Conservative
Information, advice, support
Manage underlying cause
Aetiology
Lungs
Vascular: VTE
Trauma: upper airway obstruction
Autoimmune: vasculitis
Idiopathic: OSA
Congenital: persistent pulmonary HTN of the newborn
bronchopulmonary dysplasia
Degenerative: COPD, ILD
Heart
Vascular: L-sided heart disease, pulmonary vein stenosis
Infection: HIV
Idiopathic
Congenital: L-R shunts (VSD, AVSD, PDA),
-
-
-