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Pulmonary Hypertension - Coggle Diagram
Pulmonary Hypertension
Definition
MPAP >25 at rest
MPAP >30 with exercise
PCWP >18
World Symposium on Pulmonary Hypertension
PAH with structural narrowing
Idiopathic
Drug and toxin produced
Genetic
Collagen disease
PAH with left sided heart failure
Systolic
Diastolic
Valvular
Cardiomyopathies
PAH lung disease
COPD
Interstitial
Mixed
Sleep related
Hypoventilation
Chronic thromboemblism
Pathophysiology
Increased flow ie left to right shunt
Volume resistant but pressure intolerant
Smooth muscle re-modelling
Pulmonary artery vasocontriction
enodthelal dysfunction
nitric oxide
Fibrosis
hypoxic pulmonary vasoconstriction
Small vessel pulmoanry change
ECG
P pulmonale (>2.5 in inferior leads, >1.5 in V1,V2
RAD
Tall R wave in V1 +V2
RBBB
RV strain
St depression
T wave inversion in V1-3
Cor pulmonale definition
Pressuse overload of right ventricle
Secondary to PAH
Management
Treat underlying cause
LTOT
COPD
NIV
Obstructive disease
Pulmonary endarterectomy
Anticoagulation
Medical
Diuretics
Vasodilators
Prostacylins
Endothelial receptor antagonists
Bosentan
Phosphodiesterase inhibitors
ICU poor outcomes
Hypotension
Hyponatraemia
AKI