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PULMONARYHYPERTENSION
out line:INTRODUCTION      BRIEF HISTORY           WHAT IS PH?               WHAT CAUSES PH?         SIGNS AND SYMPTOMS   ...
IntroductionIn the human body, there are two types ofcirculation that enable distribution ofblood throughout the body.The ...
IntroductionOn the other hand, the portion thatpumps deoxygenated blood from theright side of the heart via the rightventr...
INTRODUCTIONMillions of people are affected by acondition   known   as   high   bloodpressure (hypertension) whereby thebl...
Pulmonary hypertension is a less common type ofhigh blood pressure that affects the arteries inthe lungs. Pressures in the...
This disease can occur in men, women andchildren of all ages. However, it is mostcommon in females between 20 and 40 years...
Ordinarily, blood vessels in the lungs provide lessresistance to blood flow than blood vessels in the rest ofthe body . An...
Types of pulmonary hypertension
Primary Pulmonary Hypertension no underlying cause for the high blood pressurein lungs Begin with spasm of the muscle la...
causes    of   Secondary    PulmonaryHypertension• results directly from another medicalproblem•Chronic Obstructive Pulmon...
WHAT CAUSES PULMONARYHYPERTENSION?
Causes of secondary PHblood clots in the lungs (pulmonary emboli) chronic obstructive pulmonary disease such asemphysema...
Left-sided heart failure• heart’s left ventricle weakens and cannotpump out enough blood• increase in pressure backs up bl...
Pathophysiology of pulmonary       hypertension
Abnormally high BP in pulmonary arteriesIncreased pressure damages large and small pulmonaryarteries       Thickness of Bl...
Pulmonary Hypertension right side of heart must work harder         push blood through                                    ...
Functional ClassificationA. Class I- Patients with pulmonary hypertension but without   resulting limitation of physical a...
SIGNS ANDSYMPTOMS
Signs and symptoms shortness of breath fatigue or light-headed upon exertion dizziness or fainting spells (syncope) swe...
 coughing (sometimes with blood) andwheezing distended neck veins enlarged liver heart palpitations Chest pain feel ...
DIAGNOSIS OF PH
history of present illnesses past medical history Family history Any past or present medications thatthe patient may h...
Chest X-Ray
Echocardiography (Ultrasonic Cardiography)
Electrocardiogram (ECG)ECG is a record of the electrical activity produced by theheart. Abnormal rhythms (arrhythmias) may...
Pulmonary AngiogramUsed to measure circulation in the lungs and to visualizeclots in the lung on x-rays. The test involves...
Pulmonary Function TestsNon-invasive tests to measure how much airyour lungs can hold and the airflow in and out ofyour lu...
TREATMENT OF PH
fluid restriction diuretics to decrease fluid accumulation cardiac glycosides (eg, digitalis) in an attemptto improve c...
Anticoagulants such as warfarin havebeen given to patients because of chronicpulmonary emboli.Heart— lung transplantatio...
Lung and heart for transplant
Nursing Management
THANK YOU FOR YOUR ATTENTION!!
Pulmonary hypertension
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Pulmonary hypertension

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Pulmonary hypertension

  1. 1. PULMONARYHYPERTENSION
  2. 2. out line:INTRODUCTION BRIEF HISTORY WHAT IS PH? WHAT CAUSES PH? SIGNS AND SYMPTOMS DIAGNOSIS OF PH TREATMENT OF PH
  3. 3. IntroductionIn the human body, there are two types ofcirculation that enable distribution ofblood throughout the body.The portion that pumps oxygenated bloodfrom the left side of the heart via the leftventricle to all parts of the body is knownas the systemic circulation
  4. 4. IntroductionOn the other hand, the portion thatpumps deoxygenated blood from theright side of the heart via the rightventricle into the lungs to obtainoxygen is referred to as thePULMONARY CIRCULATION.
  5. 5. INTRODUCTIONMillions of people are affected by acondition known as high bloodpressure (hypertension) whereby theblood travels through the body’sarteries at a pressure higher thannormal.
  6. 6. Pulmonary hypertension is a less common type ofhigh blood pressure that affects the arteries inthe lungs. Pressures in the lung arteries are normallylower than the pressures in the systemiccirculation. Pulmonary hypertension occurs when thepressure in the pulmonary circulation becomesabnormally elevated.
  7. 7. This disease can occur in men, women andchildren of all ages. However, it is mostcommon in females between 20 and 40 yearsold.The condition is rare in children but issometimes seen in infants born with heartdefects. Pulmonary hypertension may be aprimary or secondary cause of hypoxia inneonates.
  8. 8. Ordinarily, blood vessels in the lungs provide lessresistance to blood flow than blood vessels in the rest ofthe body . And blood pressure is usually much lower inthe lungs. While pressure in general circulation is about120/80 mm Hg, in the pulmonary arteries, it is onlyaround 25/15 mm Hg.Mean (average) pulmonary artery pressure= number between highest and lowest pressures Normal at rest : 14 mm Hg Pulmonary hypertension at rest : 25 mm Hg during exercise : 30 mm Hg
  9. 9. Types of pulmonary hypertension
  10. 10. Primary Pulmonary Hypertension no underlying cause for the high blood pressurein lungs Begin with spasm of the muscle layer inpulmonary arteries patients are sensitive to substances that causeblood vessels to constrict may have an inherited predisposition for thedisease
  11. 11. causes of Secondary PulmonaryHypertension• results directly from another medicalproblem•Chronic Obstructive Pulmonary Disease,scleroderma, pulmonary fibrosis, lungdiseases such as asbestosis in thisdiseases flow of blood impedes through thelungs.
  12. 12. WHAT CAUSES PULMONARYHYPERTENSION?
  13. 13. Causes of secondary PHblood clots in the lungs (pulmonary emboli) chronic obstructive pulmonary disease such asemphysema Connective tissue disorders, such as sclerodermaUpper airway obstructed during sleep obesity with reduced ability to breathelung diseases such as pulmonary fibrosis (causesscarring in the tissue between the lungs’ air sacs)
  14. 14. Left-sided heart failure• heart’s left ventricle weakens and cannotpump out enough blood• increase in pressure backs up blood throughpulmonary veins to arteries in lungsConginital heart disease
  15. 15. Pathophysiology of pulmonary hypertension
  16. 16. Abnormally high BP in pulmonary arteriesIncreased pressure damages large and small pulmonaryarteries Thickness of Blood vessel walls Cannot transfer oxygen and carbon dioxide normally Levels of oxygen in blood fall Constriction of pulmonary arteries increase in pressure in pulmonary circulation
  17. 17. Pulmonary Hypertension right side of heart must work harder push blood through pulmonary arteries to lungs cor pulmonale right ventricle thickens and enlarges Heart FailureIn some people, the bone marrow will produce more red blood cells tocompensate for less of oxygen in blood.Extra RBCs cause the blood to become thicker and stickier, further increasingthe load on the heart Pulmonary Embolism
  18. 18. Functional ClassificationA. Class I- Patients with pulmonary hypertension but without resulting limitation of physical activity. Ordinary physical activity does not cause undue dyspnoea or fatigue, chest pain, or near syncope.B. Class II- patients with pulmonary hypertension resulting in slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity causes undue dyspnoea or fatigue, chest pain, or near syncope.C. Class III- patients with pulmonary hypertension resulting in marked. Limitation of physical activity. They are comfortable at rest. Less than ordinary activity causes undue dyspnoea, fatigue, and chest pain or near syncope.D. Class IV -patients with pulmonary hypertension with inability to carry out any physical activity without symptoms. these patients manifest signs of right heart failure. Dyspnoea and /or fatigue may be present even at rest. Discomfort is increased by any physical activity
  19. 19. SIGNS ANDSYMPTOMS
  20. 20. Signs and symptoms shortness of breath fatigue or light-headed upon exertion dizziness or fainting spells (syncope) swelling (edema) in ankles, legs andeventually in abdomen (ascites) – fluid leakout of veins and into tissues bluish colour to lips and skin (cyanosis)
  21. 21.  coughing (sometimes with blood) andwheezing distended neck veins enlarged liver heart palpitations Chest pain feel weak – body tissues not receivingenough oxygen
  22. 22. DIAGNOSIS OF PH
  23. 23. history of present illnesses past medical history Family history Any past or present medications thatthe patient may have takenphysical examination will also takeplace.
  24. 24. Chest X-Ray
  25. 25. Echocardiography (Ultrasonic Cardiography)
  26. 26. Electrocardiogram (ECG)ECG is a record of the electrical activity produced by theheart. Abnormal rhythms (arrhythmias) may indicate thatthe heart or part of the heart is undergoing unusualstress.
  27. 27. Pulmonary AngiogramUsed to measure circulation in the lungs and to visualizeclots in the lung on x-rays. The test involves insertion ofa thin catheter into the pulmonary artery through whichan iodine dye is injected.Image of any blood clots present in the lung can beobserved and circulation of blood through lung’s bloodvessels can be tracked.
  28. 28. Pulmonary Function TestsNon-invasive tests to measure how much airyour lungs can hold and the airflow in and out ofyour lungs. They can also measure the amountof gases exchanged across the membranebetween the lung wall and capillary membrane.During the tests, the patient will be asked toblow into a spirometer. An abnormality here maybe amongst the first indication of PH.
  29. 29. TREATMENT OF PH
  30. 30. fluid restriction diuretics to decrease fluid accumulation cardiac glycosides (eg, digitalis) in an attemptto improve cardiac function calcium channel blockers for vasodilation, and rest.Intravenous prostacyclin helps to decreasepulmonary hypertension by reducingpulmonary vascular resistance and pressuresand increasing cardiac output
  31. 31. Anticoagulants such as warfarin havebeen given to patients because of chronicpulmonary emboli.Heart— lung transplantation has beensuccessful in select patients with primaryhypertension who have not been responsiveto other therapies
  32. 32. Lung and heart for transplant
  33. 33. Nursing Management
  34. 34. THANK YOU FOR YOUR ATTENTION!!

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