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Questions and Answers
What is the defining characteristic of pulmonary hypertension?
What is the defining characteristic of pulmonary hypertension?
- Increased resistance and pressure in the pulmonary arteries (correct)
- Increased pressure in the systemic veins
- Decreased resistance in the pulmonary arteries
- Decreased pressure in the pulmonary veins
Pulmonary hypertension is defined as a mean pulmonary arterial pressure greater than 25 mmHg.
Pulmonary hypertension is defined as a mean pulmonary arterial pressure greater than 25 mmHg.
False (B)
What system is strained due to pulmonary hypertension?
What system is strained due to pulmonary hypertension?
right side of the heart
In pulmonary hypertension, there is back pressure through the right side of the heart and into the ______ venous system.
In pulmonary hypertension, there is back pressure through the right side of the heart and into the ______ venous system.
Match the following causes with their corresponding pulmonary hypertension group:
Match the following causes with their corresponding pulmonary hypertension group:
Which of the following is a common symptom of pulmonary hypertension?
Which of the following is a common symptom of pulmonary hypertension?
Hepatomegaly is a sign of pulmonary hypertension.
Hepatomegaly is a sign of pulmonary hypertension.
What is the main presenting symptom of pulmonary hypertension?
What is the main presenting symptom of pulmonary hypertension?
Elevated jugular venous pressure (JVP) is a sign of pulmonary hypertension due to back pressure in the ______ system.
Elevated jugular venous pressure (JVP) is a sign of pulmonary hypertension due to back pressure in the ______ system.
Match the ECG finding with what it indicates in pulmonary hypertension:
Match the ECG finding with what it indicates in pulmonary hypertension:
Which ECG finding is indicative of right ventricular hypertrophy in pulmonary hypertension?
Which ECG finding is indicative of right ventricular hypertrophy in pulmonary hypertension?
Dilated pulmonary arteries are a common finding on chest X-rays of patients with pulmonary hypertension.
Dilated pulmonary arteries are a common finding on chest X-rays of patients with pulmonary hypertension.
What blood test is typically elevated in patients with right ventricular failure due to pulmonary hypertension?
What blood test is typically elevated in patients with right ventricular failure due to pulmonary hypertension?
A(n) ______ can be used to estimate the pulmonary artery pressure.
A(n) ______ can be used to estimate the pulmonary artery pressure.
Match the management option with its corresponding mechanism of action in treating idiopathic pulmonary hypertension:
Match the management option with its corresponding mechanism of action in treating idiopathic pulmonary hypertension:
Which of the following medications is NOT typically used to treat idiopathic pulmonary hypertension?
Which of the following medications is NOT typically used to treat idiopathic pulmonary hypertension?
Secondary pulmonary hypertension is managed by directly addressing the elevated pulmonary artery pressure with vasodilators.
Secondary pulmonary hypertension is managed by directly addressing the elevated pulmonary artery pressure with vasodilators.
What is the primary focus of management for secondary pulmonary hypertension?
What is the primary focus of management for secondary pulmonary hypertension?
[Blank] treatments such as oxygen and diuretics are used for complications of pulmonary hypertension like respiratory failure or oedema.
[Blank] treatments such as oxygen and diuretics are used for complications of pulmonary hypertension like respiratory failure or oedema.
Match the treatment with the specific type of pulmonary hypertension it addresses:
Match the treatment with the specific type of pulmonary hypertension it addresses:
Which group of pulmonary hypertension is associated with systemic lupus erythematosus (SLE)?
Which group of pulmonary hypertension is associated with systemic lupus erythematosus (SLE)?
Pulmonary hypertension due to left heart failure is classified as Group 5.
Pulmonary hypertension due to left heart failure is classified as Group 5.
What is the name for peaked P waves seen on an ECG in the context of pulmonary hypertension?
What is the name for peaked P waves seen on an ECG in the context of pulmonary hypertension?
Right bundle branch block on ECG suggests right-sided ______ in pulmonary hypertension.
Right bundle branch block on ECG suggests right-sided ______ in pulmonary hypertension.
Match the pulmonary hypertension group with its primary underlying mechanism:
Match the pulmonary hypertension group with its primary underlying mechanism:
Which of the following is considered a supportive treatment, rather than a direct treatment, for pulmonary hypertension?
Which of the following is considered a supportive treatment, rather than a direct treatment, for pulmonary hypertension?
The prognosis for untreated idiopathic pulmonary hypertension is generally favorable, with most patients living more than 10 years after diagnosis.
The prognosis for untreated idiopathic pulmonary hypertension is generally favorable, with most patients living more than 10 years after diagnosis.
What specific type of pulmonary vascular disease is classified under Group 4 pulmonary hypertension?
What specific type of pulmonary vascular disease is classified under Group 4 pulmonary hypertension?
In chest x-ray findings, ______ ventricular hypertrophy suggests a long-standing strain on the right side of the heart due to pulmonary hypertension.
In chest x-ray findings, ______ ventricular hypertrophy suggests a long-standing strain on the right side of the heart due to pulmonary hypertension.
Match each class of medication for idiopathic pulmonary hypertension with its corresponding mechanism of action:
Match each class of medication for idiopathic pulmonary hypertension with its corresponding mechanism of action:
A patient with a history of COPD presents with symptoms of pulmonary hypertension. Which group of pulmonary hypertension would this patient most likely fall into?
A patient with a history of COPD presents with symptoms of pulmonary hypertension. Which group of pulmonary hypertension would this patient most likely fall into?
Raised NT-proBNP is a direct indicator of pulmonary artery pressure.
Raised NT-proBNP is a direct indicator of pulmonary artery pressure.
What is the term for swelling in the extremities that can occur as a consequence of pulmonary hypertension?
What is the term for swelling in the extremities that can occur as a consequence of pulmonary hypertension?
Right axis ______ on an ECG suggests right ventricular enlargement and potential pulmonary hypertension.
Right axis ______ on an ECG suggests right ventricular enlargement and potential pulmonary hypertension.
Match the clinical finding with the diagnostic test used to identify it in suspected pulmonary hypertension:
Match the clinical finding with the diagnostic test used to identify it in suspected pulmonary hypertension:
A patient presents with shortness of breath, syncope, and peripheral oedema. Which of the following conditions should be high on the differential diagnosis?
A patient presents with shortness of breath, syncope, and peripheral oedema. Which of the following conditions should be high on the differential diagnosis?
Left ventricular hypertrophy is a hallmark ECG finding in pulmonary hypertension.
Left ventricular hypertrophy is a hallmark ECG finding in pulmonary hypertension.
What is the key characteristic regarding the pulmonary arteries in pulmonary hypertension?
What is the key characteristic regarding the pulmonary arteries in pulmonary hypertension?
An ECG showing tall R waves in leads V1 and V2 indicates right ventricular ______ associated with pulmonary hypertension.
An ECG showing tall R waves in leads V1 and V2 indicates right ventricular ______ associated with pulmonary hypertension.
Match the cause of pulmonary hypertension with its appropriate classification:
Match the cause of pulmonary hypertension with its appropriate classification:
Flashcards
Pulmonary Hypertension
Pulmonary Hypertension
Increased resistance and pressure in the pulmonary arteries, leading to strain on the right side of the heart.
Definition of Pulmonary Hypertension
Definition of Pulmonary Hypertension
A mean pulmonary arterial pressure greater than 20 mmHg.
Group 1 Pulmonary Hypertension Cause
Group 1 Pulmonary Hypertension Cause
Often associated with connective tissue diseases – systemic lupus erythematosus is an example.
Group 2 Pulmonary Hypertension Cause
Group 2 Pulmonary Hypertension Cause
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Group 3 Pulmonary Hypertension Cause
Group 3 Pulmonary Hypertension Cause
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Group 4 Pulmonary Hypertension Cause
Group 4 Pulmonary Hypertension Cause
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Group 5 Pulmonary Hypertension Cause
Group 5 Pulmonary Hypertension Cause
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Main Symptom of Pulmonary Hypertension
Main Symptom of Pulmonary Hypertension
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Syncope in Pulmonary Hypertension
Syncope in Pulmonary Hypertension
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Tachycardia in Pulmonary Hypertension
Tachycardia in Pulmonary Hypertension
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Raised JVP in Pulmonary Hypertension
Raised JVP in Pulmonary Hypertension
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Hepatomegaly in Pulmonary Hypertension
Hepatomegaly in Pulmonary Hypertension
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Peripheral Oedema in Pulmonary Hypertension
Peripheral Oedema in Pulmonary Hypertension
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P Pulmonale
P Pulmonale
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RVH on ECG
RVH on ECG
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Right Axis Deviation
Right Axis Deviation
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Right Bundle Branch Block
Right Bundle Branch Block
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Dilated Pulmonary Arteries
Dilated Pulmonary Arteries
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Right Ventricular Hypertrophy (CXR)
Right Ventricular Hypertrophy (CXR)
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Raised NT-proBNP
Raised NT-proBNP
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Echocardiogram Use
Echocardiogram Use
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Treatment for Idiopathic Pulmonary Hypertension
Treatment for Idiopathic Pulmonary Hypertension
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Management of Secondary Pulmonary Hypertension
Management of Secondary Pulmonary Hypertension
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Supportive Treatments for Pulmonary Hypertension
Supportive Treatments for Pulmonary Hypertension
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Study Notes
Pulmonary Hypertension Overview
- Increased resistance and pressure in the pulmonary arteries defines pulmonary hypertension
- Pulmonary hypertension strains the right side of the heart as it pumps blood through the lungs
- Pulmonary hypertension causes back pressure through the right side of the heart into the systemic venous system
- Pulmonary hypertension is defined as a mean pulmonary arterial pressure greater than 20 mmHg
Causes of Pulmonary Hypertension
- Group 1: Idiopathic pulmonary hypertension or connective tissue diseases like systemic lupus erythematosus
- Group 2: Left heart failure, often from myocardial infarction or systemic hypertension
- Group 3: Chronic lung diseases, such as COPD or pulmonary fibrosis
- Group 4: Pulmonary vascular diseases like pulmonary embolism
- Group 5: Miscellaneous causes including sarcoidosis, glycogen storage disease, and haematological disorders
Signs and Symptoms
- Shortness of breath is the primary symptom
- Syncope (loss of consciousness)
- Tachycardia (rapid heart rate)
- Raised jugular venous pressure (JVP)
- Enlarged liver (hepatomegaly)
- Peripheral oedema (swelling in extremities)
Investigations
- ECG changes indicate right-sided heart strain
- P pulmonale (peaked P waves)
- Right ventricular hypertrophy, indicated by tall R waves in V1 and V2 with deep S waves in V5 and V6
- Right axis deviation
- Right bundle branch block
- Chest X-ray changes include
- Dilated pulmonary arteries
- Right ventricular hypertrophy
- Other Investigations
- Raised NT-proBNP (indicates right ventricular failure)
- Echocardiogram (estimates pulmonary artery pressure)
Management
- Untreated idiopathic pulmonary hypertension has a poor prognosis, with a mean survival of 2-3 years after diagnosis
- Treatment for idiopathic pulmonary hypertension
- Calcium channel blockers
- Intravenous prostaglandins (e.g., epoprostenol)
- Endothelin receptor antagonists (e.g., macitentan)
- Phosphodiesterase-5 inhibitors (e.g., sildenafil)
- Treatment for secondary pulmonary hypertension
- Treating the underlying cause, such as pulmonary embolism, COPD, or systemic lupus erythematosus
- Supportive treatments
- Oxygen and diuretics are used for complications such as respiratory failure, oedema, and arrhythmias
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