Pulmonary hypertension

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Background

Pulmonary Hypertension = mean PA pressure >25mmHg assessed by right heart cath

  • can be divided into:
    • precapillary PH (normal PCWP)
      • Includes Pulmonary arterial hypertension (PAH), PH due to due to lung disease, and chronic thromboembolic PH
    • postcapillary PH (elevated PCWP)
      • PH due to left heart disease

Diagnosis

Treatment

  1. No fluids
  2. Treat relative bradycardia
    1. atropine, pace, dobutamine
  3. Pulm vasodialate
    1. sildenafil, bostantan
  4. ?anticoagulate (freq PEs)
  5. Empiric abx

Source

4/07 DONALDSON (adapted from Sarver)

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