5 Questions
What is the result of excessively high PVR in persistent pulmonary hypertension (PPHN)?
Persistence of the fetal circulatory pattern of right-to-left shunting through the PDA and foramen ovale after birth
What is the consequence of lung inflation in reducing PVR?
Rapid decline in PVR
What suggests right-to-left shunting through the ductus arteriosus in PPHN?
PaO2 or oxygen saturation gradient between a preductal and a post-ductal site of blood sampling
What is the pathogenesis of PPHN related to chronic fetal hypoxia?
Increased pulmonary artery medial muscle thickness and extension of smooth muscle layers into the usually non-muscular, more peripheral pulmonary arterioles
What diagnostic tool is helpful in evaluating PPHN?
2D echo with Doppler
Study Notes
Persistent Pulmonary Hypertension (PPHN)
- Excessive PVR consequence: Right ventricular failure that may lead to cardiovascular collapse
- Lung inflation effect: Reduces PVR by recruiting and distending lung vessels, improving oxygenation and cardiovascular stability
Ductus Arteriosus Shunting
- Right-to-left shunting indication: Presence of differential cyanosis (lower limbs more cyanosed than upper limbs)
- Ductal shunting pathophysiology: Oxygenated blood from the aorta bypasses the lungs, deoxygenated blood from the pulmonary artery flows to the descending aorta
PPHN Pathogenesis
- Chronic fetal hypoxia effect: Increases pulmonary vascular resistance, leading to PPHN
- Fetal hypoxia mechanisms: Impairs vascularization, increases smooth muscle growth, and alters vascular reactivity
PPHN Diagnosis
- Diagnostic tool: Echocardiography, which helps evaluate cardiac anatomy, right ventricular function, and pulmonary artery pressure
Test your knowledge of Persistent Pulmonary Hypertension (PPHN) with this quiz. Explore the pathogenesis, right-to-left shunting through PDA and foramen ovale, and factors influencing pulmonary vascular resistance.
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