Pulmonary hypertension & right heart failure
15 important questions on Pulmonary hypertension & right heart failure
How can pulmonary hypertension be measured?
What levels for the mean pulmonary arterial pressure (mPAP) are considered to be pulmonary hypertension?
What distinction is being made in pulmonary hypertension?
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What types of pulmonary hypertension (HP) can be distinguished?
- Arterial: pulmonary arterial hypertension (PAH) Rare, can be heritable
- PH associated with lung disease (severe/mild) Common
- PH associated with pulmonary artery obstructions
- PH associated with left heart disease Very common
- Unclear/multifactorial
When is pulmonary hypertension diagnosed as PAH?
- If the LV is normal
What does PAH cause to the blood vessel?
How can PAH cause right heart problems?
How can RV adaptation be assessed?
- Right heart catheterization
- Cardiac MRI
- Echocardiography
- Pressure volume analysis
What does increased RV pressure overload because of pulmonary hypertension cause on top of RV hypertrophy?
Why do PAH patients have no contractile reserve (despite the RV being hypercontractile, due to increased force-generating capacity of the cardiomyocytes)?
- RV-arterial uncoupling
- RV fibrosis → RV stiffness
What causes RV fibrosis in PAH patients?
What is the consequence of RV diastolic stiffness for the right atrium?
What causes the inefficient RA function in PAH patients?
What does eventually happen to the RA in PAH patients?
What changes are there in RA sarcomeric function in PAH patients?
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