Pulmonary hypertension

Pulmonary hypertension

Updated: 10/07/2022

© Jun Wang, MD, PhD

 

Definition

  • Elevated pulmonary arterial pressure
    • ≥ 25 mm Hg (or 20 mm Hg + Pulmonary vascular resistance ≥ 3 Woods units, debating), or 
    • > 30 mm Hg during exercise
  • Severe pulmonary hypertension
    • mPAP is ≥ 35 mm Hg, or
    • mPAP is > 20 mm Hg with an elevated right atrial pressure (>14 mm Hg) and/or the cardiac index is <2 L/min/m2
  • Post-capillary pulmonary hypertension

WHO classification

Clinical presentations

  • Non-specific
  • Commonly with exertional dyspnea and progressive fatigue
  • Symptoms and signs of right ventricular dysfunction
    • Exertional chest pain or syncope
    • Weight gain
    • Anorexia, abdominal pain and swelling
    • Elevated jugular vein pressure
    • Right-sided 3rd or 4th heart sound,
    • Splitting of 2nd sound, or loud S2, due to increased P2 intensity 
    • Hepatomegaly, etc

Diagnostic approaches

Laboratory tests

  • Results consistent with underlying disorders
  • Brain natriuretic peptide might be elevated, but not specific

Treatments

  • Depending on classification

Practice questions

 

Back to contents

 

Comments

Post a Comment

Popular posts from this blog

Contents

Pathology notes Jun Wang, MD, PhD 1. General information Frequently discussed syndromes Terms of dermatology Terms of hematology 2. Primary immunodeficiency disorders 3. Hemodynamic abnormalities Shock Thrombosis and embolism Bleeding disorders 4. Benign white cell disorders 5. Hematopoietic neoplasms Lymphoid neoplasms Myeloid neoplasms Histiocytic neoplasms: Langerhans cell histiocytosis 6. Cardiovascular system Pulmonary hypertension Cardiovascular system tumors 7. Respiratory tract tumors 8. Gastrointestinal tract Congenital disorders Infectious gastroenteritis Oral cavity Esophagus Stomach Intestinal tumors Salivary glands Exocrine pancreas and gallbladder 9. Urinary system Kidney masses Lower urinary tract 10. Male reproductive system 11. Female genital tract 12. Breast 13. Endocrine organs Pituitary gland Adrenal gland Thyroid gland Parathyroid gland Endocrine pancreas Multiple endocrine neoplasms 14. B
Read more

Female genital tract

Pathology of female genital tract   Updated: 01/23/2024 © Jun Wang, MD, PhD Key anatomic features Opened channel, pathological basis for pelvic inflammatory disease Cervix: exocervix, endocervix, transformation zone Uterus: fundus, body Fallopian tube: intramural, isthmus, ampulla, infundibulum, fimbriae Placenta: umbilical cord, fetal membrane, placenta Key histologic features Stratified squamous epithelium from vulva to exocervix Simple columnar epithelium from endocervix to fimbriae Uterine corpus Endometrium: Glands, stroma Myometrium Perimetrium: Mesothelium/peritoneum Ovaries: three components Epithelium (mesothelium) Stroma Germ cells (follicles) Placenta: Cytotrophoblast, syncytiotrophoblast, intermediate trophoblast Infectious/inflammatory diseases Diseases of vagina and vulva Molluscum contagiosum Lichen sclerosus Paget disease Sarcoma botryoides Squamous cell carcinoma Diseases of cervix Cervical intraepithelial neopla
Read more

Neoplasms of respiratory tract

Neoplasms of respiratory tract   Updated: 11/14/2022 © Jun Wang, MD, PhD Anatomy Nasal cavity Nasopharynx Oropharynx Laryngopharynx Larynx Trachea and bronchi Lungs Histology Squamous mucosa Respiratory mucosa May have abundant lymphoid tissue in pharynx Type I and Type II pneumocytes Key risk factors Human papillomavirus: Squamous cell carcinoma, squamous cell papilloma Epstein Barr virus: Nasopharyngeal carcinoma Smoking Tumors of nasal cavity and nasopharynx Olfactory neuroblastoma Nasopharyngeal angiofibroma Sinonasal papilloma NUT midline carcinoma Nasopharyngeal carcinoma Tumors or tumor like lesions of larynx Vocal cord polyp Squamous papilloma Squamous cell carcinoma Branchial pouch/cleft anomalies Branchial cyst Thyroglossal duct cyst Neoplasms of lung Squamous cell carcinoma Adenocarcinoma Large cell carcinoma Small cell carcinoma Carcinoid Lymphangioleiomyomatosis Neoplasms of pleura Mesothelioma
Read more