pulm hypertension

  1. definition of pulmonary hypertension
    increase in the pulmonary arterial pressure abouve normal
  2. normal PAP
    25/10 mmHg
  3. primary pulmonary hypertension means
    no other diseases of the heart or lungs causing the high pulm artery pressure
  4. cause of primary pulmonary hypertension is
  5. 3 complications of secondary pulm hypertension
    • many pulmonary
    • cardiacextrathoracic conditions
  6. secondary pulmonary hypertension=
    something else
  7. unrelieved pulmonary hypertension, regardless of the underlying cause, leads to
    right ventricular failure
  8. the normal pulmonary vacsulature is a
    low pressure system with low resistance to blood flow
  9. substances can cause vasodilation by causing cells lining blood vessels to
    produce the gaseous product, nitric oxide
  10. 5 contributing factors of pulm hypertension
    • genetic predisposition
    • molecular levels of prostacyclin
    • inflammation
    • coagulation abnomalities
    • endothelial cell dysfunction
  11. nitric oxide is what type of relaxing factor
  12. NO causes
  13. prostacyclin is a potent
  14. endothelin is a potent
    vasoconstrictor (causes hypertension)
  15. idiopathic =
    unknown cause
  16. suspected in 6-10% of patients diagnosed w/ PAH
  17. 3 types of associated diseases
    • scleroderma
    • congential heart disease
    • liver disease
  18. 2 types of associated drug use
    • appetite supressant Fen Fen
    • methamphetamine (meth)
  19. PAH is associated w/ left or right heart disease?
  20. PAH is associated with lung disease or hypoxemia (copd)

    true or false?
  21. 3 types of clinical assessment
    • doppler echocardiography
    • chest xray
    • ecg
  22. measurement of right ventricle size and function using
    doppler echocardiography
  23. enlargement of the central pulm arteries
    reduction of the retrosternal space on lateral
    chest xray
  24. relatively nonspecific
    may show ST and Twave abnormalities
  25. if pulm hypertension is secondary to pulm disease, signs and symps of pulm disease typically OVERSHADOWS those of
    pulm hypertension
  26. signs and symptoms of pulm hypertension
    • DOE
    • chest pain
    • weakness
    • fatigue
    • syncope (loss of consciousness)
    • hypoxemia
  27. restrict salt intake because is can predispose
    R heart failure
  28. low level of what type of exercise?
  29. avoid pregnancy - how many percent maternal mortality rate
    30-50 %
  30. what type of meds to give if patient has right ventricular failure
    diuretics - lasex
  31. what type of med is digoxin
    calcium channel blockers
  32. flolan is what type of IV
  33. viagra is also known as
  34. bosental is what type of agonists
    endothelin receptor
  35. nitric oxide is naturally producd in the body in the
    upper and lower airways
  36. iNO (nitric oxide) is not approved for
    adults by the FDA
  37. NO selectively dilates
    pulm blood vessels
  38. hemoglobin inactivates
    nitric oxid
  39. NO2 is a byproduct of NO and oxygen and is a highly toxic chem therefore it must be
    monitored closely
  40. how much amts of NO and oxy should be used
    very little as possible
  41. inhaled NO can cause formation of
  42. methemoglobin levels should be monitored closely and should maintain at less than
  43. 2 types of surgical options
    • atrial septostomy
    • lung transportation
  44. creation of a right to left interatrial shunt to increase cardiac output is what type of septostomy
  45. reserved for those patients that fail best available medical therapy
    lung transplant
  46. how many percent is the survival rate after getting a lung transplant
  47. median duration of a survival after the diagnosis of primary pulm hypertension is
    2.8 years
  48. patients w/out evidence of R ventricular dysfunction may survive for more than
    10 years
  49. prognosis for secondary pulm hypertension depends on the
    underlying disease, as well as R vent function
  50. type of patient that has a three year mortality rate of 50% after the onset of R vent failure
Card Set
pulm hypertension
pulm hypertension 1