PULMONARY HYPERTENSION : PULMONARY HYPERTENSION Conducted by: Ms.Monika Clinical instructor Army college of nursing INTRODUCTION: INTRODUCTION pulmonary hypertension (PH or PHT) is an increase in blood pressure in the pulmonary artery , pulmonary vein , or pulmonary capillaries. It is also defined as a prolonged elevation of pulmonary artery pressure above 25 mmhg at rest (normal 10 to 20 mmhg) or above 30 mm hg during exercise.( normal 20 to 30 mm hg) Cont…………..d: Cont…………..d Pulmonary hypertension can be a severe disease with a markedly decreased exercise tolerance and heart failure . It occurs most often in young adults b/w the age of 30 & 40 years. The condition is progressive ,leading to right sided heart failure & severe dyspnea. Etiology : Etiology The pulmonary circulation is generally a low pressure system. Increased cardiac output in healthy person as with exercise causes minimal elevation in PAP. When pulmonary vasoconstriction is present ,the pressure elevation occurs because the pulmonary vasculature cannot accommodate increased blood flow. Clinical manifestation : Clinical manifestation In moderate to severe forms mainifestation are: Dyspnea Fatigue fainting or syncope Angina like chest pain Palpitations Muscular weakness. peripheral edema (swelling around the ankles and feet), and rarely hemoptysis (coughing up blood). Pulmonary venous hypertension typically presents with shortness of breath while lying flat or sleeping Diagnostic evaluation : Diagnostic evaluation A physical examination is performed to look for typical signs of pulmonary hypertension. Further procedures are required to confirm the presence of pulmonary hypertension. These generally include pulmonary function tests ; blood tests to exclude HIV , autoimmune diseases, and liver disease; electrocardiography (ECG); arterial blood gas measurements; X-rays of the chest (followed by high-resolution CT scanning if interstitial lung disease is suspected); and ventilation-perfusion or V/Q scanning . Cont………….d: Cont………….d A chest x-ray study shows right ventricular hypertrophy ,enlarged pulmonary arteries Cardiac catheterization provides the most valuable diagnostic measurement. Medical management: Medical management The overall prognosis in severe [pulmonary hypertension is poor ,although treatment options are improving. Supportive interventions with supplemental o2 to reduce hypoxemia. Anticoagulants may be used to prevent thromboembolic events. Vasodilator therapy is the pharmacologic management.