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Pulmonary Hypertension: Difference between revisions
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Pulmonary hypertension is a rare cause of high blood pressure(hypertension) in the pulmonary artery(pulmonary artery). When the blood vessels of the lungs becomes damaged, such as in pulmonary arterial hypertension, the thickening and stiffening of the pulmonary artery walls occur which causes deviations in the vessel wall. The consequence of this is that the pressure in the pulmonary artery rises and also in the RV. PH is a pressure load on the right heart. Click [http://www.youtube.com/watch?v=ROz1XSWwxR4 '''here'''] to see an animation about PH. | Pulmonary hypertension is a rare cause of high blood pressure (hypertension) in the pulmonary artery (pulmonary artery). When the blood vessels of the lungs becomes damaged, such as in pulmonary arterial hypertension, the thickening and stiffening of the pulmonary artery walls occur which causes deviations in the vessel wall. The consequence of this is that the pressure in the pulmonary artery rises and also in the RV. PH is a pressure load on the right heart. Click [http://www.youtube.com/watch?v=ROz1XSWwxR4 '''here'''] to see an animation about PH. | ||
==WHO classification== | ==WHO classification== | ||
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!Likely | !Likely | ||
|- | |- | ||
!SPAP | |||
|<36 mmHg | |align="center"|<36 mmHg | ||
|36-50 mmHg | |align="center"|36-50 mmHg | ||
|>50 mmHg | |align="center"|>50 mmHg | ||
|- | |- | ||
!TR Vmax | |||
|<2.8 m/s | |align="center"|<2.8 m/s | ||
|2.9-3.4 m/s | |align="center"|2.9-3.4 m/s | ||
|>3.4 m/s | |align="center"|>3.4 m/s | ||
|- | |- | ||
!AccT | |||
|>120 ms | |align="center"|>120 ms | ||
|120-60 ms | |align="center"|120-60 ms | ||
|<60 ms | |align="center"|<60 ms | ||
|- | |- | ||
!RV MPI (TCO-ET/ET) | |||
|<0.36 | |align="center"|<0.36 | ||
| | | | ||
| | | | ||
|- | |- | ||
!RV MPI (TDI) | |||
|<0:50 | |align="center"|<0:50 | ||
| | | | ||
| | | | ||
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!Formula | !Formula | ||
|- | |- | ||
!Systolic PA pressure | |||
|4 x(TR Vmax)<sup>2</sup> + estimated RA pressure | |4 x(TR Vmax)<sup>2</sup> + estimated RA pressure | ||
|- | |- | ||
!Diastolic PA pressure | |||
|4 x(PR Ved)<sup>2</sup> + estimated RA pressure | |4 x(PR Ved)<sup>2</sup> + estimated RA pressure | ||
|- | |- | ||
!rowspan="4" valign="top"|Mean PA pressure | |||
|0.3 x systolic PA pressure + 0.6 x diastolic PA pressure | |0.3 x systolic PA pressure + 0.6 x diastolic PA pressure | ||
|- | |- | ||
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|} | |} | ||
==Examples of severe pulmonary hypertension<cite>1</cite>== | |||
Short | {| class="wikitable" cellpadding="0" cellspacing="0" border="0" | ||
|- | |||
Increased Systolic PA pressure Increased MPI, extension of isovolumetric times | |[[Image:PVAccT02.jpg|400px]] | ||
|Video | |||
|- | |||
!Short AccT with "systolic notch" | |||
!Flattened septum | |||
|- | |||
|[[Image:SPAP01.jpg|400px]] | |||
|[[Image:PAH01.jpg|400px]] | |||
|- | |||
!Increased Systolic PA pressure | |||
!Increased MPI, extension of isovolumetric times | |||
|} | |||
==References== | ==References== | ||
<biblio> | <biblio> | ||
#1 pmid= | #1 pmid=22941889 | ||
</biblio> | </biblio> | ||