pulmonary hypertension
DESCRIPTION
TRANSCRIPT
BY
DR LAILA
PULMONARY HYPERTENSION
• Pulmonary vascular circuit has a very low resistance
• Carries a volume of 70ml of blood.
NORMAL
Normally Increased blood flow in lung bases
as compared to the apices d/t
gravity
NORMAL PULMONARY VASCULATURE
Minimal blood flow to apices
• Inadequate LA pressure
• Vessel diameter in upper intercostal spaces is not more than 3mm
• Main pulmonary artery diameter is 16mm in males and 15mm in females.
An increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting n eventually heart failure
Pulmonary hypertension
Sustained elevation of mean pulmonary arterial pressure to greater than 25 mmHg at rest
or
more than 30 mmHg during exercise, with normal pulmonary capillary wedge pressure and left ventricular end-diastolic pressure (<15 mm Hg)
PAH
WHO Classification of pulmonary hypertension
Group 1. Pulmonary artery hypertension (PAH)
Idiopathic Familial
Group 2. Pulmonary hypertension with left heart diseaseGroup 3. Pulmonary hypertension associated with lung disease and/or hypoxaemiaGroup 4. Pulmonary hypertension due to chronic thrombotic and/or embolic diseaseGroup 5. Miscellaneous (sarcoidosis, histiocytosis X, lymphangiomyomatosis, compression of pulmonary vessels)
)
CXR• Hilar pulmonary arterial dilation.
• Loss of peripheral blood vessel markings
OR
• Peripheral pruning
• Enlarged right atrium and right ventricle in advanced diseases
PAH
PULMONARY VENOUS HYPERTENSION
PULMONARY INTERSTITIAL EDEMA
KERLEY B LINES
PERIBRONCHIAL CUFFING
FISSURE EFFUSION
CEPHALIZATION
CEPHALIZATION
PULMONARY ALVEOLAR EDEMA
PULMONARY ALVEOLAR EDEMA
PULMONARY ALVEOLAR EDEMA
PULMONARY HAEMOSIDEROSIS
Longstanding pulmonary venous HTN leads to pulmonary hemosiderosis (punctate calcific) ossific nodules (< 1cm)
THANK YOU