Pathology Notes

Pulmonary hypertension due to left heart disease Updated: 09/14/2022 © Jun Wang, MD, PhD   General features Post-capillary pulmonary hypertension Commonly seen in pts with heart failure Usually poor prognosis Subclassification Isolated post-capillary PH (Ipc-PH): Elevated mPAP solely due to passive transmission of increased left-sided filling pressure to the pulmonary circulation Combined post- and precapillary PH (Cpc-PH): Elevated mPAP due to passive transmission of increased left-sided filling pressures with superimposed pulmonary vascular disease Pathogenesis Response to increase in left-side filling pressure   Clinical features Presentation of left heart diseases History of left heart diseases: infarct, etc Left ventricular dysfunction Pulmonary crackles S3 or S4 heart sound Presentation of right heart failure Loud P2 Right ventricular heave Elevated jugular vein Hepatomegaly Presentation of pulmonary hypertension Key morphological features Prolifera

Practice questions answers Shock © Jun Wang, MD, PhD   1. A. Presentations of fever and chills are suspicious of infection. In addition, this patient has lower abdominal pain with image studies showing extraluminal gas or feces, consistent with ruptured internal organ, most likely colon. The presence of tachypnea, tachycardia and skin cyanosis is highly suggestive for shock , further supported by persistent hypotension after adequate fluid resuscitation. In this case, this is most likely a septic shock , due to presentations of sepsis . Although diagnosis of sepsis is usually made empirically based on clinical presentations, especially evidence of organ dysfunctions, it is commonly required to have either positive blood culture results or clinical responses to antibiotics to confirm the diagnosis. Chest X-ray and echocardiography are used in diagnosis of obstructive shock . EKG can be used to diagnose cardiogenic shock . Flow cytometry can be used in diagnosis of lymphoid n