Pulmonary hypertension (PH) refers to elevated pulmonary artery pressure (PAP) and is commonly defined as mean PAP≥25mmHg. The presence of PH does not indicate any specific pathologic or physiologic cause. This distinction is underappreciated, with consequent confusion in both clinical practice and the medical literature.
Prognosis in PH is predicted by underlying cause, pathophysiology and the interaction between the right heart and pulmonary circulation. The degree of elevation in PAP itself is not the main cause of adverse effects of PH and lowering PAP is not the focus of therapy. This is in contrast to systemic arterial hypertension, where elevated pressure itself causes many subsequent events such as chronic kidney disease and cerebrovascular accident, with therapy being directly aimed at lowering systemic arterial pressure. PH is common among adults with congenital heart disease (CHD). Almost 6% of adults with CHD carry a diagnosis of PH; this subset of patients has a higher risk of hospitalization and death.1 Over 1/3rd of complex ACHD hospitalizations in the United States involve a diagnosis of PH.2 The epidemiology of PH associated with congenital heart disease (PH-CHD), however, is poorly defined, with data based on widely disparate diagnostic techniques and definitions (detailed below). Most importantly, PH is often conflated with pulmonary arterial hypertension (PAH), which refers to PH characterized by elevated PVR but normal pulmonary venous pressure (Table 1). While PH-CHD is stereotypically attributed to high PVR (e.g., Eisenmenger syndrome), elevated pulmonary venous pressure, lung disease, chronic thromboembolism and extrinsic compression of pulmonary vascular structures are all common contributors. Therefore,...
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Additionally, some of the general diagnostic and pulmonary function tests are distinct in emphysema in comparison to chronic bronchitis. In the case of R.S. the arterial blood gas (ABG) values are the following: pH=7.32, PaCO2= 60mm Hg, PaO2= 50 mm Hg, HCO3- = 80mEq/L. R.S.’s laboratory findings are indicative of chronic bronchitis, where the pH and PaO2 are decreased, whereas PaCO2 and HCO3- are increased, when compare to normal indices. Based on the arterial blood gas evaluation, the physician can deduce that the increased carbon dioxide is due to the airway obstruction displayed by the hypoventilation. Furthermore the excessive mucus production in chronic bronchitis hinders proper oxygenation leading to the hypoxia. On the other hand, in emphysema the arterial blood gas values would include a low to normal PaCO2 and only a slight decrease in PaO2 which tend to occur in the later disease stages.
“Hypoplastic left heart syndrome accounts for 9% of all critically ill newborns with congenital cardiac disease, causing the largest number of cardiac deaths in the first year of life.(2) ” HLHS is a severe heart defect that is present at birth. HLHS combines different defects that result in an underdeveloped left side of the heart. This syndrome is one of the most challenging and difficult to manage of all of the congenital heart defects. Multiple portions on the left side of the heart are affected including the left ventricle, the mitral and aortic valve, and the ascending aorta. These structures are greatly reduced in size, or completely nonexistent causing the functionality of the left heart to be reduced, or non-functional all together.
My clinical rotation for NURN 236 is unique in that all patients I care for at Union Memorial Hospital in Baltimore, Maryland have a diagnosis of heart failure (HF). HF occurs when the heart is unable to pump adequate blood supply, resulting in insufficient oxygen and nutrients to the tissues of the body (Smeltzer, Bare, Hinkle, and Cheever, 2012). Approximately 670,000 Americans are diagnosed with HF each year and is the most common hospital discharge diagnosis among the elderly (Simpson, 2014). Moreover, according to the Centers for Medicare and Medicaid Services (CMS), HF is the leading cause of 30-day hospital readmission followed by acute myocardial infarction (AMI) and pneumonia (medicare.gov|Hospital Compare, 2013).
Tetralogy of Fallot is a congenital heart disease which involves four different heart defects in one. The four different heart defects are a large ventricular septal defect (VSD), Pulmonary Stenosis, Right ventricular hypertrophy, and an overriding aorta. These congenital defects change the normal flow of blood thro...
Hypertension can be defined as a force exerted against the wall of blood vessels. However, high blood pressure occurs when there is high pressure at the time of ventricle contraction during the systolic phase against decrease contract during diastolic phase as the ventricles relax and refill. This can be recorded as systolic over diastolic in millimeters of mercury. (Wallymahmed, M. 2008).
2017). As the pressure from the volume of blood retaining in the left atrium builds up, it can
" Journal of Clinical Hypertension 13.5 (2011): 351-56. EBSOHost.com - a. Web. The Web.
This condition is close to me because I have the early signs of Primary Pulmonary Arterial Hypertension (PPAH) and I have family members that have died or currently have this condition. Pulmonary arterial hypertension is a progressive disorder characterized by high blood pressure in the pulmonary artery, the blood vessel that carries blood from the heart to the lungs. Pulmonary arterial hypertension occurs when increased pressure cannot fully overcome the elevated resistance and blood flow to the body is insufficient. To overcome the pressure that increases in the pulmonary artery and in the heart chamber that pumps blood into the right ventricle. Treatments for PPH focus on symptoms and include several
NIH. National Heart, Lung, and Blood Institute, 22 Feb. 2012. Web. 12 May 2014. .
Blood pressure is measured by two pressures; the systolic and diastolic. The systolic pressure, the top number, is the pressure in the arteries when the heart contracts. The diastolic pressure, the bottom number, measures the pressure between heartbeats. A normal blood pressure is when the systolic pressure is less than 120mmHg and Diastolic pressure is less than 80mmHg. Hypertension is diagnosed when the systolic pressure is greater than 140mmHg and the diastolic pressure is greater than 90mmHg. The physician may also ask about medical history, family history, life style habits, and medication use that could also contribute to hypertension
Cardiofaciocutaneous syndrome is a very rare and serious genetic disorder that generally affects the heart, facial features, and skin of an individual. It is caused by a desultory gene mutation, which takes place in one of four genes. Those genes are known as BRAF, MEK1, MEK2, and KRAS. From research, it is also suspected there is a possibility that other genes are associated with the rare condition. This disorder holds multiple alternative names, a long history, obvious symptoms, extensive amounts of interesting data, and is lucky enough to be supported by numerous organizations that will stop at nothing to help.
The patient interviewed is a 21-year-old Caucasian female who will be referred to as C.L.; she was recently diagnosed with Pulmonary Hypertension (PH) and wants to seek more information about how to manage the disease. She is currently a nursing student at the University of Minnesota who enjoys playing soccer, being a part of her student organizations, and hanging out with her friends. C.L. experiences symptoms and complications such as dyspnea (shortness of breath), dizziness, chest pain, activity intolerance, and weakness due to her PH. These symptoms are felt when she exerts herself too much. Recently, every day activities such as walking have made her experience these symptoms, which is why she came to the clinic. She has a very supportive family that consists of a twin sister –who also goes to the University of Minnesota—and her two parents who want to help in any way they can.
Pulmonary Fibrosis is a condition where the lung tissue becomes thick and scarred. The thickening and scarring of the lungs makes it hard for the oxygen supply to be delivered throughout the body. The scarring can be caused by many different factors, but it is hard for doctors to figure out exactly what caused the onset of this disease. The damage caused by this disease cannot be repaired. Pulmonary Fibrosis usually affects the age group of forty to seventy years old. Men are more likely to develop this disease, but women can also get this disease. Pulmonary Fibrosis is not a transmittable disease. Little is actually known about how the disease develops. There seems to be a genetic connection and environmental factors that cause the disease to develop.
... patients with heart failure: Impact on patients. American Journal of Critical Care, 20(6), 431-442.
My first patient that was assigned to me was a 50-year-old woman admitted for coughing and nose bleeds. She states that she has been bleeding for the last two to three days. After coughing, she had chest pains that would go away and come back. Her admitting diagnosis was CAD. The patient had past medical history of NSTEMI and chronic diastolic failure, coronary angioplasty, chest pain and hypertension and hyperlipidemia. My assessments went very smoothly. She was able to tell me that she experienced shortness of breath upon exertion. She was not experiencing any pain. Further, I was able to find that she was hypertensive at 148/89. I looked into her issue and discovered that her nose bleeding may be related to HTN because high blood pressure