Pulmonary hypertension

1. BY DR LAILA PULMONARY HYPERTENSION

2. Pulmonary vascular circuit has a very low resistance Carries a volume of 70ml of blood. NORMAL

3. Normally Increased blood flow in lung bases as compared to the apices d/t gravity NORMAL PULMONARY VASCULATURE

4. Minimal blood flow to apices Inadequate LA pressure Vessel diameter in upper intercostal spaces is not more than 3mm Main pulmonary artery diameter is 16mm in males and 15mm in females .

5. An increase in blood pressure in the pulmonary artery , pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting n eventually heart failure Pulmonary hypertension

6. Sustained elevation of mean pulmonary arterial pressure to greater than 25 mmHg at rest or more than 30 mmHg during exercise, with normal pulmonary capillary wedge pressure and left ventricular end-diastolic pressure (<15 mm Hg) PAH

7. WHO Classification of pulmonary hypertension Group 1 . Pulmonary artery hypertension (PAH)    Idiopathic Familial Group 2. Pulmonary hypertension with left heart disease Group 3 . Pulmonary hypertension associated with lung disease and/or hypoxaemia Group 4 . Pulmonary hypertension due to chronic thrombotic and/or embolic disease Group 5 . Miscellaneous ( sarcoidosis , histiocytosis X, lymphangiomyomatosis , compression of pulmonary vessels) )

8. CXR Hilar pulmonary arterial dilation. Loss of peripheral blood vessel markings OR Peripheral pruning Enlarged right atrium and right ventricle in advanced diseases PAH

9. PULMONARY VENOUS HYPERTENSION

10. PULMONARY INTERSTITIAL EDEMA

11. KERLEY B LINES

12. PERIBRONCHIAL CUFFING

13. FISSURE EFFUSION

14. CEPHALIZATION

15. CEPHALIZATION

16. PULMONARY ALVEOLAR EDEMA

17. PULMONARY ALVEOLAR EDEMA

18. PULMONARY ALVEOLAR EDEMA

19. PULMONARY HAEMOSIDEROSIS

20. Longstanding pulmonary venous HTN leads to pulmonary hemosiderosis (punctate calcific) ossific nodules (< 1cm)

21. THANK YOU