• Definition
    • 🍒What is the formal definition of pulmonary hypertension?
  • Pathophysiology and Aetiology
    • 🍒What is the formula for calculating pulmonary pressure
    • High LA pressure is the most common cause (e.g. left sided heart failure or valve disease)
      • This is called pulmonary venous hypertension
      • 🍒What is pulmonary venous hypertension and what is it caused by?
    • Pulmonary vascular ristance can be caused by:
      • Chronic hypoxaemia (e.g. COPD, Obstructive Sleep Apnoea, living at high altitude)→ vasoconstriction
      • Chronic pulmonary emboli → decreased area for blood flow
      • Pulmonary arterial hypertension ⇒ basically essential hypertension in pulmonary system
        • Hyperplasia of intimal of smooth muscle
        • Associations:
          • Connective tissue disease (scleroderma)
          • Chronic use of Traditional amphetamines and synthetic cathinone and Cocaine
          • Congenital heart disease (shunts)
        • Idiopathic pulmonary hypertension
          • Classically affects young women (20-40)
          • Manamgement
            • Bosentan and Sildenafil
  • Classification
    • 🍒What is the WHO classification of pulmonary hypertension?
    • 🍒What is the WHO functional classification of pulmonary hypertension
  • Management
    • Non specific therapies
      • 🍒What is the anticoagulant management for chronic thromboembolic pulmonary hypertension
      • 🍒Diuretics are used for patients with right heart failure secondary to pulmonary hypertension, particularly if oedema is present
      • 🍒Digoxin is occasionally prescribed for patients with right heart failure or a low cardiac output
    • Specific therapies
      • Because of the severe nature of pulmonary hypertension and the complexity of treatment, it is rarely appropriate to interrupt therapy
        • Studies have demonstrated worsening disease progression and rebound pulmonary hypertension even with brief treatment interruptions
        • Seek advice from a pulmonary hypertension specialist if an interruption to therapy is being considered (eg for an operation); retitration may be required when restarting therapy
      • 🍒What specific therapies are available for pulmonary arterial hypertension (group 1) and chronic thromboembolic pulmonary hypertension (group 4)?
      • 🍒Young females with pulmonary hypretension should consider contraception