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pulm hypertension
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definition of pulmonary hypertension
increase in the pulmonary arterial pressure abouve normal
normal PAP
25/10 mmHg
primary pulmonary hypertension means
no other diseases of the heart or lungs causing the high pulm artery pressure
cause of primary pulmonary hypertension is
unknown
3 complications of secondary pulm hypertension
many pulmonary
cardiacextrathoracic conditions
secondary pulmonary hypertension=
something else
unrelieved pulmonary hypertension, regardless of the underlying cause, leads to
right ventricular failure
the normal pulmonary vacsulature is a
low pressure system with low resistance to blood flow
substances can cause vasodilation by causing cells lining blood vessels to
produce the gaseous product, nitric oxide
5 contributing factors of pulm hypertension
genetic predisposition
molecular levels of prostacyclin
inflammation
coagulation abnomalities
endothelial cell dysfunction
nitric oxide is what type of relaxing factor
endothelium-derived
NO causes
vasoconstriction
prostacyclin is a potent
vasodilator
endothelin is a potent
vasoconstrictor (causes hypertension)
idiopathic =
unknown cause
suspected in 6-10% of patients diagnosed w/ PAH
familial
3 types of associated diseases
scleroderma
congential heart disease
liver disease
2 types of associated drug use
appetite supressant Fen Fen
methamphetamine (meth)
PAH is associated w/ left or right heart disease?
left
PAH is associated with lung disease or hypoxemia (copd)
true or false?
True
False
true
3 types of clinical assessment
doppler echocardiography
chest xray
ecg
measurement of right ventricle size and function using
doppler echocardiography
enlargement of the central pulm arteries
reduction of the retrosternal space on lateral
chest xray
relatively nonspecific
may show ST and Twave abnormalities
ECG
if pulm hypertension is secondary to pulm disease, signs and symps of pulm disease typically OVERSHADOWS those of
pulm hypertension
signs and symptoms of pulm hypertension
DOE
chest pain
weakness
fatigue
syncope (loss of consciousness)
hypoxemia
restrict salt intake because is can predispose
R heart failure
low level of what type of exercise?
aerobic
avoid pregnancy - how many percent maternal mortality rate
30-50 %
what type of meds to give if patient has right ventricular failure
diuretics - lasex
what type of med is digoxin
calcium channel blockers
flolan is what type of IV
epoprostenol
viagra is also known as
sildenafil
bosental is what type of agonists
endothelin receptor
nitric oxide is naturally producd in the body in the
upper and lower airways
iNO (nitric oxide) is not approved for
adults by the FDA
NO selectively dilates
pulm blood vessels
hemoglobin inactivates
nitric oxid
NO2 is a byproduct of NO and oxygen and is a highly toxic chem therefore it must be
monitored closely
how much amts of NO and oxy should be used
very little as possible
inhaled NO can cause formation of
methemoglobin
methemoglobin levels should be monitored closely and should maintain at less than
5%
2 types of surgical options
atrial septostomy
lung transportation
creation of a right to left interatrial shunt to increase cardiac output is what type of septostomy
atrail
reserved for those patients that fail best available medical therapy
lung transplant
how many percent is the survival rate after getting a lung transplant
66-75%
median duration of a survival after the diagnosis of primary pulm hypertension is
2.8 years
patients w/out evidence of R ventricular dysfunction may survive for more than
10 years
prognosis for secondary pulm hypertension depends on the
underlying disease, as well as R vent function
type of patient that has a three year mortality rate of 50% after the onset of R vent failure
COPD
Author
Anonymous
ID
46421
Card Set
pulm hypertension
Description
pulm hypertension 1
Updated
2010-11-01T06:55:06Z
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