Tag Archives: cardiac

Pulmonary hypertension

mean PAP > 25 mm Hg

Classification:

  1. Pulmonary arterial e.g. IPAH, systemic sclerosis, congenital heart disease
  2. Secondary to left heart disease
  3. Secondary to chronic lung disease
  4. Chronic thromobo-embolic
  5. Multifactorial/unknown

ECHO features:

  • Estimation of sPAP in Apical 4-Chamber view. PH likely if estimated sPAP>50 mm Hg
  • Other features of PH: dilated right side chambers, reduced RV function, RVH, enlarged PA, abnormal inter-ventricular septum motion

Management:

  • Ca-channel blockade
  • Prostacyclin
  • Endothelin receptor antagonists
  • NO
  • PDE-5 inhibitor
  • TREAT PRIMARY CAUSE
  • consider (CTPA) +/- treat VTE
  • diuretics

http://www.escardio.org/guidelines-surveys/esc-guidelines/guidelinesdocuments/guidelines-ph-ft.pdf