Presentation
Finally, there are no outcomes presented from these cohorts, although certainly, the authors are tracking these data prospectively. The insights reported by Thenappan and colleagues 5 raise new questions for consideration. [ahajournals.org]
PVH patients presented with higher mPAP, right atrial mean pressure and lower pulmonary vascular resistance (PVR). [academic.oup.com]
Dyspnoea and/or fatigue may even be present at rest. Discomfort is increased by any physical activity. [rcemlearning.co.uk]
Pulmonary hypertension due to left heart disease is a pathophysiological and hemodynamic state which is present in a wide range of clinical conditions that affect left heart structures. [revespcardiol.org]
Researchers have shown that two or more of these features were present in 94.1% of PH-LHD patients vs. only 34.3% of PAH ( 18 ). [frontiersin.org]
Entire Body System
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Congestive Heart Failure
In the hands of ohm: hemodynamic aspects in pulmonary hypertension 2019 (English) Doctoral thesis, comprehensive summary (Other academic) Abstract [en] Congestive heart failure (CHF) is one of the most challenging diseases in terms of health care demand [diva-portal.org]
It is well-known that pulmonary alveolar diffusion is impaired in patients with congestive heart failure. Gas transfer factor for carbon monoxide (TLco) is reduced in this population compared to controls ( 25 ). [frontiersin.org]
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Inflammation
The lung biopsy showed chronic granulomatous inflammation. With surgery a pedunculated mass was found in the left atrium, and removed. [jamanetwork.com]
Respiratoric
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Productive Cough
A housewife 29 years of age complained of increasing dyspnea, productive cough, and wheezing respiration. A characteristic murmur of mitral stenosis was noted. [jamanetwork.com]
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Exertional Dyspnea
Exertional dyspnea, orthopnea, and/or paroxysmal nocturnal dyspnea, anginal chest pain typically on exertion, palpitations, dry cough, pre-syncope and/or syncope, hepatomegaly, ascites, elevated jugular venous pressure, and peripheral edema are the most [frontiersin.org]
Cardiovascular
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Heart Failure
These questions are the focus of an interesting study by Thenappan and colleagues 5 in this issue of Circulation: Heart Failure. [ahajournals.org]
None of the patients had systolic left heart failure. One hundred and forty-six patients (36%) had PH and served as a control group. PVH patients presented with higher mPAP, right atrial mean pressure and lower pulmonary vascular resistance (PVR). [academic.oup.com]
Thus, there might be lower amounts of lung oedema for the same level of pulmonary venous hypertension in chronic with respect to acute left heart failure conditions. [oxfordmedicine.com]
B: heart failure and mild "passive" pulmonary hypertension. C:advanced heart failure and severe"reactive" pulmonary hypertension. [revespcardiol.org]
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Vascular Disease
"Pulmonary hypertension in COPD: epidemiology, significance, and management: pulmonary vascular disease: the global perspective". Chest. 137 (6 Suppl): 39S–51S. doi : 10.1378/chest.10-0087. PMID 20522579. [en.wikipedia.org]
Electrocardiography to define clinical status in primary pulmonary hypertension and pulmonary arterial hypertension secondary to collagen vascular disease. Chest 2002;122:524-7. [rcemlearning.co.uk]
A simple echocardiographic score for the diagnosis of pulmonary vascular disease in heart failure. J Cardiovasc Med. (2017) 18 :237–43. doi: 10.2459/JCM.0000000000000485 PubMed Abstract CrossRef Full Text Google Scholar 39. [frontiersin.org]
Psychiatrical
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Suggestibility
The pulmonary function studies with arterial oxygen determinations suggested the diagnosis of interstitial fibrosis; and catheterization of the right heart revealed pulmonary vascular hypertension. [jamanetwork.com]
PAH is suggested when an echocardiogram-derived estimate of pulmonary arterial systolic pressure exceeds 40 mm Hg at rest. [rcemlearning.co.uk]
The authors' data suggest that we should think twice in that scenario. [ahajournals.org]
Conclusion: A PAcT 90ms is strongly suggestive of increased PVR ( 3.0 WU). Based on study 1, there is clear evidence suggesting that these findings apply irrespective of LVFPs. [diva-portal.org]
Neurologic
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Confusion
PH” do in fact have elevated PA pressures, as defined by current criteria. 1 With increasing recognition of the prevalence and importance of PH in HF and pulmonary disease, it will be important to use precise, easily understood terminology to avoid confusion [ahajournals.org]
Workup
X-Ray
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Pericardial Effusion
Finally, a RV end-diastolic diameter to LV end-diastolic diameter ratio (measured in the 4-chamber apical view at the tips of the atrioventricular valves) 1 and the absence of pericardial effusion seem to be more likely in PH-LHD than PAH ( 20 ). [frontiersin.org]
Treatment
The treatments and mechanisms underlying PAH and HFpEF are quite different, so distinction of one from the other is of obvious clinical importance. [ahajournals.org]
Likewise, no drug approved forthe treatment of heart failure is contraindicated dueto the presence of PH. 3 In a substantial number of patients, PH associatedwith systolic heart failure is at least partially reversiblewith pharmacological treatment, as [revespcardiol.org]
Re: 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The joint task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology and the European Respiratory Society; European [rcemlearning.co.uk]
Treatment PAH targeted therapies act on three distinct pathophysiological pathways. [frontiersin.org]
BACKGROUND: Various etiologies of pulmonary hypertension (PH) have different mechanisms and treatments for breathlessness. [diva-portal.org]
Prognosis
Subdividing the PVH group according to TPG revealed an inferior prognosis for patients with TPG 12 mmHg compared to a TPG 12 mmHg (p 0.024). Conclusions: PVH with HFpEF is a frequent finding in end-stage COPD (13%). [academic.oup.com]
Jump to: Top Introduction Clinical assessment Investigation Strategies Management Prognosis & Followup strategies MedicoLegal and other considerations References Prognosis & Followup strategies The main pitfall in the ED management of PH is not maintaining [rcemlearning.co.uk]
These factors are also essential for determining prognosis and must be taken into account when making some of the most important therapeutic decisions. The pathophysiological process starts passively but later transforms into a reactive process. [revespcardiol.org]
Tricuspid annular plane systolic excursion and pulmonary arterial systolic pressure relationship in heart failure: an index of right ventricular contractile function and prognosis. [frontiersin.org]
Increased pulmonary vascular resistance (PVR), commonly found in pre-capillary PH, is a condition that shares many symptoms with CHF, and is also associated with poor prognosis. [diva-portal.org]
Etiology
BACKGROUND: Various etiologies of pulmonary hypertension (PH) have different mechanisms and treatments for breathlessness. [diva-portal.org]
In the most recent clinical classification of PH ( 5 ) two additional etiologies of PH-LHD have been recognized: PH due to congenital or acquired left ventricular outflow tract obstruction and pulmonary vein stenosis. [frontiersin.org]
Epidemiology
"Obesity Hypoventilation Syndrome Epidemiology and Diagnosis". Sleep Medicine Clinics. 9 (3): 341–347. doi : 10.1016/j.jsmc.2014.05.007. PMC 4210766. PMID 25360072. Reynolds, PN (February 2011). [en.wikipedia.org]
An epidemiological study of pulmonary arterial hypertension in Scotland. Eur Respir J 2007;30:104-9. Hoeper MM, Rubin LJ. Update in Pulmonary Hypertension 2005. Am J Respir Crit Care Med 2006;173:499-505. Rich S. [rcemlearning.co.uk]
Pulmonary hypertension in heart failure: epidemiology, right ventricular function, and survival. Am J Respir Crit Care Med. (2015) 192 :1234–46. doi: 10.1164/rccm.201503-0529OC PubMed Abstract CrossRef Full Text Google Scholar 8. [frontiersin.org]
Pathophysiology
Secondary pulmonary hypertension in chronic heart failure: the role of the endothelium in pathophysiology and management. Circulation. 2000 ; 102 :1718–1723. Crossref Medline Google Scholar 5. [ahajournals.org]
Pathophysiology The pathophysiological hallmark of PH-LHD is elevated LAP. [frontiersin.org]
British Journal of Anaesthesia: "Primary pulmonary hypertension in pregnancy; a role for novel vasodilators" Archived 2011-01-21 at the Wayback Machine March 19, 2011 "Primary Pulmonary Hypertension: Practice Essentials, Background, Pathophysiology". [en.wikipedia.org]
The World Health Organization (WHO) diagnostic classification of PH has 5 classes based on pathophysiology and aetiology (Box 1). [rcemlearning.co.uk]
The pathophysiological process starts passively but later transforms into a reactive process. [revespcardiol.org]
Prevention
Acute arrhythmias require prompt management with the aim of restoring sinus rhythm and preventing recurrence of the arrhythmia (21). Establishing the diagnosis and aetiology requires early referral to a specialist PH unit (21). [rcemlearning.co.uk]
[…] by sodium restriction and diuretics, and,finally, prevention of tachyarrhythmia or controlof heart rate to optimize diastolic filling time with b-blockers or calcium antagonists. [revespcardiol.org]