Pulmonary Hypertension (PH)

Info

🌱 來自: Huppert’s Notes

Pulmonary Hypertension (PH)🚧 施工中

Pulmonary Hypertension (PH)

•   Note: See Cardiology Chapter 1 for additional details

•   Classifications of PH: Mneumonic = AVRT Other

-   Group 1: Arterial- Primary PAH. SLE, scleroderma, toxins (methamphetamine, cocaine), HIV

•   Dx: Utox, ANA, RF, TTE, HIV, hepatitis serologies, LFTs

•   Tx: PDE5 inhibitor (first line, e.g., sildenafil), endothelin receptor antagonists (second line), prostacyclins (third line, e.g., Flolan), and treat underlying cause. Consider lung transplant referral.

-   Group 2: Venous- Back up from left heart due to cardiac disease (valve disease, cardiomyopathy)

•   Dx: Right heart cath, TTE

•   Tx: Diuresis

-   Group 3: Respiratory, due to pulmonary disease- OSA, COPD

•   Dx: High-resolution chest CT, sleep study, PFTs

•   Tx: Supplemental oxygen, treat underlying disease

-   Group 4: Thromboembolic disease (i.e., chronic PEs)

•   Dx: VQ scan (preferred over CT-PE to diagnose chronic PEs)

•   Tx: Anticoagulation

-   Group 5: Other: Sarcoid, sickle cell, hemolytic anemia, metabolic disease