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Pulmonary Hypertension:Beyond the S
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What is the Big Deal?• Patients w
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Independent Predictor of Mortality
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Etiology• Noxious stimuli exposur
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Components
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Pathways Implicated in PHTNTXA2Pre
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Components• Prostacyclin- Prostag
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Abnormalities in CoagulationPlatele
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Pathophysiology• Increased flow-
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Pathophysiology• Low resistance,
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Pathophysiology ProgressionDeath
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ClassificationARTERIAL• Idopathic
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ARTERIAL HYPERTENSION
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Pulmonary Arterial Hypertension•
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Collagen Vascular Disease• Sclero
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Portopulmonary HTN• Portal HTN +
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Methamphetamine• Amphetamine, met
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VENOUS HYPERTENSION
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Left Heart Disease• LV systolic d
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LV Pressure‐Volume Curvehttp://ww
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Congenital Heart Disease• Systemi
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PHTN associated with lungdisease/hy
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Thromboembolic Disease• Thromboem
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Miscellaneous• Sarcoidosis• His
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SYMPTOMSAnd then I felttired…
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Signs and Symptoms• Dyspnea- Most
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Physical Exam• Prominent, split,
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ECG Changes• Right‐axis deviati
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CXRwww.emedicine.com/RADIO/topic583
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V/Q Scanwww.emedicine/RADIO/topic58
- Page 62 and 63: Echohttp://www.emedicine.com/med/im
- Page 64 and 65: DIAGNOSIS
- Page 66 and 67: Diagnostic Tests• BNP- Increased
- Page 68 and 69: Vasoreactivity Testing• RHC• Va
- Page 70 and 71: Management Goals• Improve functio
- Page 72 and 73: Nocturnal Desaturationwww.rnceus.co
- Page 74 and 75: Digoxin• Controversial- No mortal
- Page 76 and 77: Specific Concerns with Anticoagulat
- Page 78 and 79: Treatment For LV sided Heart Diseas
- Page 80 and 81: Action of Current PHTN TherapiesTXA
- Page 82 and 83: Survival and Prostacyclin• 162 pa
- Page 84 and 85: The ‘Other’ Prostacyclin Analog
- Page 86 and 87: Phosphodiesterase Inhibitors• Inh
- Page 88 and 89: Action of Current PHTN TherapiesPre
- Page 90 and 91: Endothelin Receptor Antagonists•
- Page 92 and 93: Nitric Oxide• Increases intracell
- Page 94 and 95: Nitric Oxide• Vascular effects- D
- Page 96 and 97: Weaning Nitric Oxide• Case Study
- Page 98 and 99: Surgical Options• Pulmonary Endar
- Page 100 and 101: Pulmonary Endartectomywww.emedicine
- Page 102 and 103: FUTURE THERAPIES
- Page 104 and 105: Action of PHTN TherapiesTXA2Pre‐P
- Page 106 and 107: Serotonin Antagonists• “Treatme
- Page 108 and 109: More Hope…• Perhaps the inhibit
- Page 110 and 111: You knew this next one was coming
- Page 114 and 115: WorkUp• Autoantibody tests, HIV t
- Page 116 and 117: One More Thought…• …most of t
- Page 118 and 119: References• Herve, P., Launay, J.
- Page 120: References• Nagaya, N., Nishikimi