Pulmonary Hypertension (Pul HTN)

Pulmonary Hypertension

 Types

1. Primary pulmonary hypertension

2. Due to LHF

3. Due to lung disease, e.g. COPD

4. Due to chronic venous thrombotic disease

5. Everything else: e.g. inflammatory, metabolic, blood and kidney disorders

Secondary pulmonary HTN: types 2-5. 

 Primary Pulmonary Hypertension

Background

Presentation

• Syncope

• Progressive reduced exercise tolerance

• Tricuspid or pulmonary regurgitation (secondary to pulmonary HTN increased pressure

• Hepatomegaly

Investigations

• ECHO: RVH

• CXR: may be normal

• HRCT ?primary lung disease ?ILD

Management

1. Endothelin A receptor antagonists: bosentan

Pregnancy

Pregnancy with pulmonary hypertension comes with a significant risk to the mother and baby. 

Management

• Prostacyclin analogues

• Anticoagulation considered

• Educated on worsening cardiac function and risk to mother & foetus

References

1. Pulmonary hypertension - victor chang cardiac research institute (no date) The Victor Chang Cardiac Research Institute. Available at: https://www.victorchang.edu.au/heart-disease/pulmonary-hypertension (Accessed: 07 October 2024).

Written in 2022