Pulmonary Hypertension

Combined from chalk talks given by Brandon Fainstad, MD and Yilin Zhang, MD. 


OBJECTIVES:

  • Differences between the 5 groups of pulmonary hypertension
  • Initial evaluation and work-up of patients with newly diagnosed pulmonary hypertension
  • Primary and advanced therapies for each group of pulmonary hypertension


CHALK TALK:

Definition of pulmonary hypertension:
Groups of pulmonary hypertension: 
Work-up of pulmonary hypertension:
Treatment of pulmonary hypertension:

TAKE HOME POINTS:

  • PH is defined by mPAP > 25 mmHg and is definitively diagnosed on RHC.
  • There are 5 groups of PH – 1) PAH 2) left heart disease 3) chronic lung disease 4) chronic thromboemboli 5) miscellaneous.
  • Patients with suspected PH should undergo evaluation with a TTE, PFTs, VQ scan, nocturnal oximetry and laboratory testing to evaluate the underlying cause.
  • All patients with PH should be managed with salt restriction, oxygen, and cautious diuresis. Advanced vasodilator therapies are typically only beneficial in group 1 PH.

ADDITIONAL LEARNING:

Vasoreactivity Testing and Choosing Advanced Therapies


REFERENCES:

  1. McLaughlin, VV, et al. ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertenion. Journal of American College of Cardiology. 2009; 53(17): 1573 – 1619.