TOPIC 9 Pulmonary vascular disorders Topic Contents Pulmonary hypertension 89 Definition 89 Incidence 89 Causes and Classification (ESC Guidelines 2004) 89 Investigations 90 Commonly used vaso-active dugs for vasodilator study drug 91 Algorithm for investigation suspected pulmonary hypertension 91 Management 91 Pulmonary thromboembolism 93 Risk factors 93 Investigations 94 Treatment 94 Pulmonary hypertension Definition Mean pulmonary artery pressure (PAP): > 25 mmHg at rest > 30 mmHg with exercise. Incidence Estimated at 500–1000 new cases annually Approximately 2–3 per million per year with a prevalence of 15 per million Occurs in men, women and children of all ages Most common in females between 20 and 40 years old (M:F 1:2) Rare in children, but sometimes seen in infants born with valvular defects. Causes and Classification (ESC Guidelines 2004) 1. Pulmonary arterial hypertension (PAH) 1.1. Idiopathic pulmonary arterial hypertension (IPAH) 1.2. Familial pulmonary arterial hypertension (FPAH) 1.3. Associated with APAH 1.3.1. Connective tissue disease 1.3.2. Congenital systemic to pulmonary shunts 1.3.3. Portal hypertension 1.3.4. HIV infection 1.3.5. Drugs and toxins 1.3.6. Other 1.4. Associated with significant venous or capillary involvement 1.4.1. Pulmonary veno-occlusive disease (PVOD) 1.4.2. Pulmonary capillary haemangiomatosis 1.5. Persistent pulmonary hypertension of the newborn (PPHN) 2. Pulmonary hypertension associated with left heart disease 2.1. Left-sided atrial or ventricular heart disease 2.2. Left-sided valvular heart disease 3. Pulmonary hypertension associated with lung respiratory disease/hypoxia 3.1. Chronic obstructive pulmonary disease 3.2. Interstitial lung disease 3.3. Sleep disordered breathing 3.4. Alveolar hypoventilation disorders 3.5. Chronic exposure to high altitude 3.6. Developmental abnormalities 4. Pulmonary hypertension due to chronic thrombotic and/or embolic disease 4.1. Thromboembolic obstruction of proximal pulmonary arteries 4.2. Thromboembolic obstruction of distal pulmonary arteries Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: 10: Systemic vascular disease 3: Preventative cardiology 2: Evaluation of myocardial ischaemia 5: Ventricular function Stay updated, free articles. Join our Telegram channel Join Tags: Cardiology Churchills Ready Reference Jun 5, 2016 | Posted by admin in CARDIOLOGY | Comments Off on 9: Pulmonary vascular disorders Full access? Get Clinical Tree
TOPIC 9 Pulmonary vascular disorders Topic Contents Pulmonary hypertension 89 Definition 89 Incidence 89 Causes and Classification (ESC Guidelines 2004) 89 Investigations 90 Commonly used vaso-active dugs for vasodilator study drug 91 Algorithm for investigation suspected pulmonary hypertension 91 Management 91 Pulmonary thromboembolism 93 Risk factors 93 Investigations 94 Treatment 94 Pulmonary hypertension Definition Mean pulmonary artery pressure (PAP): > 25 mmHg at rest > 30 mmHg with exercise. Incidence Estimated at 500–1000 new cases annually Approximately 2–3 per million per year with a prevalence of 15 per million Occurs in men, women and children of all ages Most common in females between 20 and 40 years old (M:F 1:2) Rare in children, but sometimes seen in infants born with valvular defects. Causes and Classification (ESC Guidelines 2004) 1. Pulmonary arterial hypertension (PAH) 1.1. Idiopathic pulmonary arterial hypertension (IPAH) 1.2. Familial pulmonary arterial hypertension (FPAH) 1.3. Associated with APAH 1.3.1. Connective tissue disease 1.3.2. Congenital systemic to pulmonary shunts 1.3.3. Portal hypertension 1.3.4. HIV infection 1.3.5. Drugs and toxins 1.3.6. Other 1.4. Associated with significant venous or capillary involvement 1.4.1. Pulmonary veno-occlusive disease (PVOD) 1.4.2. Pulmonary capillary haemangiomatosis 1.5. Persistent pulmonary hypertension of the newborn (PPHN) 2. Pulmonary hypertension associated with left heart disease 2.1. Left-sided atrial or ventricular heart disease 2.2. Left-sided valvular heart disease 3. Pulmonary hypertension associated with lung respiratory disease/hypoxia 3.1. Chronic obstructive pulmonary disease 3.2. Interstitial lung disease 3.3. Sleep disordered breathing 3.4. Alveolar hypoventilation disorders 3.5. Chronic exposure to high altitude 3.6. Developmental abnormalities 4. Pulmonary hypertension due to chronic thrombotic and/or embolic disease 4.1. Thromboembolic obstruction of proximal pulmonary arteries 4.2. Thromboembolic obstruction of distal pulmonary arteries Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: 10: Systemic vascular disease 3: Preventative cardiology 2: Evaluation of myocardial ischaemia 5: Ventricular function Stay updated, free articles. Join our Telegram channel Join Tags: Cardiology Churchills Ready Reference Jun 5, 2016 | Posted by admin in CARDIOLOGY | Comments Off on 9: Pulmonary vascular disorders Full access? Get Clinical Tree
