The document summarizes updates from the 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. It discusses:
1. Revised definitions and classifications of PH, with emphasis on PAH and CTEPH.
2. Updated assessment of clinical status, including WHO functional classification and echocardiography findings.
3. Current treatments for PAH focused on prostacyclins, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, and soluble guanylate cyclase stimulators. Treatments for other PH groups are still limited.
Dr. Nannika Pradhan presented on pulmonary hypertension (PH). The key points discussed include:
1. PH is defined as a mean pulmonary arterial pressure ≥25 mmHg at rest as assessed by right heart catheterization.
2. PH is classified clinically into 5 groups based on etiology.
3. Clinical features include dyspnea, chest pain, syncope, signs of right heart failure. Diagnosis involves echocardiogram, CT scan, ventilation-perfusion scan and right heart catheterization.
4. Treatment depends on disease severity and involves diuretics, oxygen supplementation, calcium channel blockers, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, prostano
The guidelines provide recommendations for the diagnosis and treatment of pulmonary hypertension. They were developed by the Joint Task Force of the European Society of Cardiology and European Respiratory Society, and endorsed by several other societies. The guidelines include information on the pathology, pathobiology, screening, and quality of life measurements related to various forms of pulmonary hypertension.
Pulmonary hypertension with cardiac shunt determinationDr. Rajesh Das
Pulmonary hypertension (PH) can be caused by cardiac shunts. The document discusses PH, including definitions, pathogenesis, classification, diagnosis, and cardiac shunt determination. It provides details on evaluating PH associated with cardiac shunts, such as estimating shunt size using oxygen saturation measurements from different chambers (oximetric method) during cardiac catheterization. The oximetric method involves obtaining blood samples from various locations to measure oxygen content and identify significant step-ups indicating the direction and location of shunts.
Human: Thank you for the summary. Can you provide a more concise summary in 2 sentences or less?
The document discusses pulmonary hypertension (PH) due to lung disorders. It defines PH and classifies it based on its underlying causes. PH due to lung diseases and hypoxia (group 3 PH) is associated with obstructive lung diseases like COPD, restrictive lung diseases, mixed lung diseases, and hypoxia without lung disease. Symptoms include dyspnea, fatigue, and signs of right heart failure as PH progresses. Imaging like echocardiogram and right heart catheterization are used to diagnose and assess severity of PH. Treatment involves managing the underlying lung condition, supportive therapies, and in severe cases, pulmonary arterial hypertension therapies may be considered though data is limited in group 3 PH. Prognosis is typically progressive with increased mortality
Pulmonary hypertension (PH) is defined as a mean pulmonary arterial pressure > 25 mmHg. It is classified into 5 groups, including pulmonary arterial hypertension (PAH), PH due to left heart disease, PH due to lung diseases/hypoxia, chronic thromboembolic PH, and PH with unclear mechanisms. Clinical symptoms include dyspnea, fatigue, chest pain, syncope, edema, and cough. Diagnostic tests involve echocardiogram, chest X-ray, ECG, and right heart catheterization. Management includes supportive therapies, calcium channel blockers, endothelin receptor antagonists, phosphodiesterase inhibitors, prostacyclins, and transplantation.
10 Take-home messages of the 2022 ESC/ERS Guidelines for the diagnosis and ...magdyelmasry3
Hemodynamic classification of pulmonary hypertension
Three categories of PH:
pre-capillary (Pre-PH),
combined pre-and-post capillary (Cpc-PH),
and isolated post-capillary (Ipc-PH).unexplained dyspnea or signs/symptoms suggesting PH .3 different drug classes
Nitric Oxide Pathway( PDE-5is and sGCs ).PAH (without cardiopulmonary comorbidities and non-vasoresponders
Endothelin Pathway( ERA )
Prostacyclin Pathway( PCA & PRA )Comprehensive risk assessment in PAH
Current diagnosis and management of PAH from cardiologist point of view財團法人風濕病基金會台灣抗風濕病聯盟
1. Pulmonary arterial hypertension (PAH) is often misdiagnosed or diagnosed late due to non-specific symptoms. Right heart catheterization is the gold standard diagnostic test.
2. PAH can be classified into 5 groups, with Group 1 including idiopathic PAH and PAH associated with conditions like connective tissue diseases.
3. PAH progresses from a reversible stage of endothelial dysfunction and vasoconstriction to an irreversible stage involving structural changes to the pulmonary vasculature. This leads to increased pulmonary vascular resistance and pressures over time.
Nick H. Kim, MD, Richard N. Channick, MD, and Vallerie V. McLaughlin, MD, prepared useful Practice Aids pertaining to pulmonary hypertension for this CME activity titled "Pulmonary Hypertension at the Crossroads of Current Clinical Challenges and Novel Therapeutic Strategies." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2O9QbOh. CME credit will be available until July 30, 2019.
Dr. Nannika Pradhan presented on pulmonary hypertension (PH). The key points discussed include:
1. PH is defined as a mean pulmonary arterial pressure ≥25 mmHg at rest as assessed by right heart catheterization.
2. PH is classified clinically into 5 groups based on etiology.
3. Clinical features include dyspnea, chest pain, syncope, signs of right heart failure. Diagnosis involves echocardiogram, CT scan, ventilation-perfusion scan and right heart catheterization.
4. Treatment depends on disease severity and involves diuretics, oxygen supplementation, calcium channel blockers, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, prostano
The guidelines provide recommendations for the diagnosis and treatment of pulmonary hypertension. They were developed by the Joint Task Force of the European Society of Cardiology and European Respiratory Society, and endorsed by several other societies. The guidelines include information on the pathology, pathobiology, screening, and quality of life measurements related to various forms of pulmonary hypertension.
Pulmonary hypertension with cardiac shunt determinationDr. Rajesh Das
Pulmonary hypertension (PH) can be caused by cardiac shunts. The document discusses PH, including definitions, pathogenesis, classification, diagnosis, and cardiac shunt determination. It provides details on evaluating PH associated with cardiac shunts, such as estimating shunt size using oxygen saturation measurements from different chambers (oximetric method) during cardiac catheterization. The oximetric method involves obtaining blood samples from various locations to measure oxygen content and identify significant step-ups indicating the direction and location of shunts.
Human: Thank you for the summary. Can you provide a more concise summary in 2 sentences or less?
The document discusses pulmonary hypertension (PH) due to lung disorders. It defines PH and classifies it based on its underlying causes. PH due to lung diseases and hypoxia (group 3 PH) is associated with obstructive lung diseases like COPD, restrictive lung diseases, mixed lung diseases, and hypoxia without lung disease. Symptoms include dyspnea, fatigue, and signs of right heart failure as PH progresses. Imaging like echocardiogram and right heart catheterization are used to diagnose and assess severity of PH. Treatment involves managing the underlying lung condition, supportive therapies, and in severe cases, pulmonary arterial hypertension therapies may be considered though data is limited in group 3 PH. Prognosis is typically progressive with increased mortality
Pulmonary hypertension (PH) is defined as a mean pulmonary arterial pressure > 25 mmHg. It is classified into 5 groups, including pulmonary arterial hypertension (PAH), PH due to left heart disease, PH due to lung diseases/hypoxia, chronic thromboembolic PH, and PH with unclear mechanisms. Clinical symptoms include dyspnea, fatigue, chest pain, syncope, edema, and cough. Diagnostic tests involve echocardiogram, chest X-ray, ECG, and right heart catheterization. Management includes supportive therapies, calcium channel blockers, endothelin receptor antagonists, phosphodiesterase inhibitors, prostacyclins, and transplantation.
10 Take-home messages of the 2022 ESC/ERS Guidelines for the diagnosis and ...magdyelmasry3
Hemodynamic classification of pulmonary hypertension
Three categories of PH:
pre-capillary (Pre-PH),
combined pre-and-post capillary (Cpc-PH),
and isolated post-capillary (Ipc-PH).unexplained dyspnea or signs/symptoms suggesting PH .3 different drug classes
Nitric Oxide Pathway( PDE-5is and sGCs ).PAH (without cardiopulmonary comorbidities and non-vasoresponders
Endothelin Pathway( ERA )
Prostacyclin Pathway( PCA & PRA )Comprehensive risk assessment in PAH
Current diagnosis and management of PAH from cardiologist point of view財團法人風濕病基金會台灣抗風濕病聯盟
1. Pulmonary arterial hypertension (PAH) is often misdiagnosed or diagnosed late due to non-specific symptoms. Right heart catheterization is the gold standard diagnostic test.
2. PAH can be classified into 5 groups, with Group 1 including idiopathic PAH and PAH associated with conditions like connective tissue diseases.
3. PAH progresses from a reversible stage of endothelial dysfunction and vasoconstriction to an irreversible stage involving structural changes to the pulmonary vasculature. This leads to increased pulmonary vascular resistance and pressures over time.
Nick H. Kim, MD, Richard N. Channick, MD, and Vallerie V. McLaughlin, MD, prepared useful Practice Aids pertaining to pulmonary hypertension for this CME activity titled "Pulmonary Hypertension at the Crossroads of Current Clinical Challenges and Novel Therapeutic Strategies." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2O9QbOh. CME credit will be available until July 30, 2019.
Treatment strategies for pulmonary hypertensionSarfraz Saleemi
There is currently no cure for pulmonary hypertension (PAH). Treatment aims to alleviate symptoms, improve quality of life, and delay disease progression. Initial treatment involves lifestyle modifications and medications such as prostacyclins, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors. Combination therapy and newer treatments targeting cellular processes show promise. Ongoing monitoring assesses treatment response through physical exams, functional tests, labs, and imaging to optimize therapy.
The document summarizes the new 2015 ESC guidelines on the diagnosis and management of pericardial diseases. It discusses epidemiological data on pericarditis which shows it accounts for 0.1% of hospital admissions. More data is needed from different geographical areas. It also discusses the aetiology of pericardial diseases which can be infectious, non-infectious, autoimmune, neoplastic, traumatic or iatrogenic. Acute pericarditis is discussed along with recommendations for diagnosis and treatment including use of aspirin, NSAIDs, colchicine or corticosteroids. Recurrent pericarditis is also covered.
2020 International Society of Hypertension Global Hypertension Practice Guide...Angela Fonseca Latino
This document provides an overview and summary of the 2020 International Society of Hypertension (ISH) Global Hypertension Practice Guidelines. It begins with an introduction stating the purpose and motivation for developing worldwide guidelines. It describes the guideline development process, including the composition of the guidelines committee. The document then provides definitions of hypertension based on blood pressure readings and classifications of blood pressure levels. It outlines recommendations for diagnosing hypertension through office blood pressure measurements and details proper measurement techniques. The summary highlights the key goals and approaches of the 2020 ISH Global Hypertension Practice Guidelines.
Pulmonary hypertension is defined as a mean pulmonary artery pressure greater than 25 mmHg. It is classified based on whether the elevation in pressure is pre-capillary or post-capillary. The pathogenesis involves various changes in the pulmonary vasculature that lead to increased pulmonary vascular resistance. Diagnosis involves symptoms, physical exam findings, imaging like echocardiogram, and right heart catheterization. Treatment aims to improve hemodynamics and symptoms through pulmonary vasodilators and diuretics. Anesthetic management of pulmonary hypertension patients requires optimizing preload, afterload, and contractility while avoiding triggers of pulmonary hypertension. Close monitoring is important both intraoperatively and postoperatively.
The document discusses guidelines from the 2015 ESC on the diagnosis and management of pericardial diseases. It provides an overview of key sections and recommendations from the guidelines. The sections discussed include epidemiology of pericardial diseases, aetiology of pericardial diseases, acute pericarditis, and recurrent pericarditis. It emphasizes the need to gather more specific epidemiological data from different geographical areas to better understand differing aetiologies. It also notes that the most frequent cause of pericarditis (idiopathy) is not fully understood and warrants further examination.
1) Pulmonary hypertension (PH) is defined as elevated pulmonary artery pressure, while pulmonary arterial hypertension (PAH) is a subtype caused by constriction and remodeling of small pulmonary arteries.
2) PAH is a progressive disease that involves proliferation of cells in the pulmonary arteries leading to increased pulmonary vascular resistance and right heart failure if left untreated.
3) The document reviews classification of PH, diagnostic testing and evaluation algorithms, goals of treatment, and approved therapies for PAH.
This document provides guidelines for the management of hypertension from the International Society of Hypertension (ISH). It aims to provide evidence-based recommendations that are practical for both low and high resource settings.
The guidelines were developed by extracting evidence from recently published guidelines and tailoring them to be concise and easy to use globally. They define hypertension as a blood pressure over 140/90 mmHg based on office measurements. The guidelines recommend lifestyle modifications and pharmacological treatment for confirmed hypertension. They also provide guidance on diagnostic tests, risk factors, target organ damage, comorbidities and special circumstances like pregnancy. The goal is to reduce the global burden of raised blood pressure through practical standards of care.
Newest 2020 ISH global hypertension practice guidelinesChanRyan4
This document provides an introduction and table of contents for guidelines on the management of hypertension. It aims to provide evidence-based recommendations tailored for both high and low resource settings. The guidelines were developed by extracting content from recently published extensively reviewed guidelines. It recognizes that optimal care may not always be possible, so essential standards of care are provided that recognize limitations in clinical evidence and resources. The motivation for developing these guidelines is the large global burden of raised blood pressure, with awareness, treatment and control rates especially low in low- and middle-income countries.
This document provides guidelines for the management of hypertension from the International Society of Hypertension (ISH). It aims to extract evidence-based recommendations from major guidelines and tailor them for both high and low resource settings. Section 1 introduces the context and purpose of the guidelines, which is to reduce the global burden of raised blood pressure. It notes that while over 1 billion people have hypertension, rates of awareness, treatment and control remain low, especially in low- and middle-income countries. The guidelines thus seek to provide practical, globally-applicable recommendations to improve hypertension management worldwide.
1) A 55-year-old woman presented with shortness of breath and was found to have right ventricular hypertrophy on ECG. Echocardiogram showed an atrial septal defect with pulmonary hypertension.
2) A 35-year-old woman with shortness of breath for 3 years was found to have mitral stenosis and pulmonary hypertension on echocardiogram.
3) A pregnant 25-year-old woman had severe pulmonary hypertension found on echocardiogram.
Translational Updates in HF: Evolving Science for the Practicing ClinicianDuke Heart
This document discusses recent translational updates in heart failure (HF) for clinicians. It begins by defining pulmonary hypertension (PH) and its subtypes. It then reviews current PAH therapies and recent clinical trials. Precision medicine approaches in PAH are also discussed. A phase 2 trial of the drug sotatercept in PAH is summarized, which aims to treat PAH by targeting transforming growth factor-beta signaling. The document concludes by noting treatment of PH is guided by diagnosis and current PAH treatment focuses on combination therapy and achieving low risk status, while challenges include treating non-Group 1 PH and patients who change PH groups.
The document describes an acute respiratory distress syndrome (ARDS) care plan. It defines ARDS as hypoxemia and bilateral lung opacities caused by diffuse alveolar damage. The care plan outlines the clinical signs of ARDS including respiratory distress, hypoxemia on blood gases, and bilateral opacities on chest x-ray. The therapeutic goals are supportive care to prevent complications, manage hypoxemia, and decrease oxygen consumption. Monitoring parameters include daily assessment of oxygenation using the PF ratio and ventilator settings. The care plan recommends a lung protective ventilation strategy using low tidal volumes, sedation, conservative fluid management, and treating any infections.
This document presents the 2018 guidelines for the management of arterial hypertension from the European Society of Cardiology and the European Society of Hypertension. It was developed by a task force of experts and provides an updated definition of hypertension, classifications of blood pressure, prevalence and risks associated with elevated blood pressure, as well as guidelines for blood pressure measurement, evaluation of hypertension-mediated organ damage, and treatment strategies. The guidelines emphasize the importance of assessing total cardiovascular risk and refining risk based on the presence of organ damage in hypertensive patients.
Pulmonary hypertension (PH) is defined as a mean pulmonary arterial pressure >20 mm Hg at rest. It can be caused by various conditions and is classified into 5 groups. Symptoms include dyspnea, fatigue, edema and syncope. Diagnosis involves ECG, echocardiogram, cardiac MRI and right heart catheterization. Treatment includes diuretics, oxygen therapy, calcium channel blockers, endothelin receptor antagonists, PDE5 inhibitors, prostacyclin analogs and lung transplantation in severe cases. Portopulmonary hypertension (POPH) occurs in 5% of cirrhosis patients and is treated similarly to PH but CCBs are generally avoided due to risk of worsening symptoms.
This document discusses pulmonary hypertension (PH), including its definition, classification, pathophysiology, clinical evaluation, diagnostic studies, and treatment. PH is defined as a mean pulmonary artery pressure greater than 25 mmHg and is classified into 5 groups. The pathophysiology involves sustained vasoconstriction, vascular remodeling, in situ thrombosis, and increased arterial wall thickness. Clinical features are often nonspecific, so diagnosis can be delayed over 2 years on average from symptom onset. Physical examination may reveal signs of right heart failure.
Advances in understanding PAH include genetic discoveries that identify targets for new treatments and risk assessment tools that help guide clinical decisions. Diagnosis has improved with a comprehensive clinical classification of PH and case illustrations. Treatment evidence has advanced through randomized trials of new drugs and procedures like BPA for CTEPH, while composite endpoints in trials require careful interpretation. Updated 2018 algorithms guide the treatment of PAH and CTEPH.
1) HFpEF is the most common form of heart failure, affecting over 70% of heart failure patients over age 65. It is associated with substantial morbidity and mortality.
2) HFpEF is challenging to diagnose because ejection fraction is normal and cardiac congestion is difficult to evaluate non-invasively. It is defined hemodynamically as a clinical syndrome associated with a lack of capacity of the heart to pump blood adequately without elevated cardiac filling pressures.
3) There is currently no effective pharmacological treatment for HFpEF. Treatment focuses on controlling congestion through diuretics, managing comorbidities, and promoting exercise. Future efforts to better characterize HFpEF phenotypes may allow individualized therapies
Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary arterial resistance leading to right heart failure. PAH can be idiopathic, familial due to genetic mutations, or associated with other conditions. Symptoms include breathlessness, but are nonspecific, often leading to underdiagnosis. Diagnosis requires right heart catheterization to measure blood pressure and rule out other causes. Recent treatment advances have improved prognosis, but lung transplantation remains an option for severe cases.
This document summarizes pulmonary hypertension and its management. It discusses the pulmonary circulation and pressures, types and classification of pulmonary hypertension, pathogenesis involving various molecular pathways, clinical diagnosis using echocardiography, right heart catheterization, and treatment goals and strategies. The main treatment approaches discussed are calcium channel blockers, prostanoids, endothelin receptor antagonists, phosphodiesterase inhibitors, and soluble guanylate cyclase stimulators. The goals of treatment are to palliate symptoms, improve exercise tolerance and right ventricular function, and strive to improve survival rates.
THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...Nursing Mastery
Title: Unlocking the Wonders of the Special Senses: Sight, Sound, Smell, Taste, and Balance
Introduction:
Welcome to our captivating SlideShare presentation on the Special Senses, where we delve into the extraordinary capabilities that allow us to perceive and interact with the world around us. Join us on a sensory journey as we explore the intricate structures and functions of sight, sound, smell, taste, and balance.
The special senses are our primary means of experiencing and interpreting the environment, each sense providing unique and vital information that shapes our perceptions and responses. These senses are facilitated by highly specialized organs and complex neural pathways, enabling us to see a vibrant sunset, hear a symphony, savor a delicious meal, detect a fragrant flower, and maintain our equilibrium.
In this presentation, we will:
Visual System (Sight): Dive into the anatomy and physiology of the eye, exploring how light is converted into electrical signals and processed by the brain to create the images we see. Understand common vision disorders and the mechanisms behind corrective measures like glasses and contact lenses.
Auditory System (Hearing): Examine the structures of the ear and the process of sound wave transduction, from the outer ear to the cochlea and auditory nerve. Learn about hearing loss, auditory processing, and the advances in hearing aid technology.
Olfactory System (Smell): Discover the olfactory receptors and pathways that enable the detection of thousands of different odors. Explore the connection between smell and memory and the impact of olfactory disorders on quality of life.
Gustatory System (Taste): Uncover the taste buds and the five basic tastes – sweet, salty, sour, bitter, and umami. Delve into the interplay between taste and smell and the factors influencing our food preferences and eating habits.
Vestibular System (Balance): Investigate the inner ear structures responsible for balance and spatial orientation. Understand how the vestibular system helps maintain posture and coordination, and explore common vestibular disorders and their effects.
Through engaging visuals, interactive diagrams, and insightful explanations, we aim to illuminate the complexities of the special senses and their profound impact on our daily lives. Whether you're a student, educator, or simply curious about how we perceive the world, this presentation will provide valuable insights into the remarkable capabilities of the human sensory system.
Join us as we unlock the wonders of the special senses and gain a deeper appreciation for the intricate mechanisms that allow us to experience the richness of our environment.
Treatment strategies for pulmonary hypertensionSarfraz Saleemi
There is currently no cure for pulmonary hypertension (PAH). Treatment aims to alleviate symptoms, improve quality of life, and delay disease progression. Initial treatment involves lifestyle modifications and medications such as prostacyclins, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors. Combination therapy and newer treatments targeting cellular processes show promise. Ongoing monitoring assesses treatment response through physical exams, functional tests, labs, and imaging to optimize therapy.
The document summarizes the new 2015 ESC guidelines on the diagnosis and management of pericardial diseases. It discusses epidemiological data on pericarditis which shows it accounts for 0.1% of hospital admissions. More data is needed from different geographical areas. It also discusses the aetiology of pericardial diseases which can be infectious, non-infectious, autoimmune, neoplastic, traumatic or iatrogenic. Acute pericarditis is discussed along with recommendations for diagnosis and treatment including use of aspirin, NSAIDs, colchicine or corticosteroids. Recurrent pericarditis is also covered.
2020 International Society of Hypertension Global Hypertension Practice Guide...Angela Fonseca Latino
This document provides an overview and summary of the 2020 International Society of Hypertension (ISH) Global Hypertension Practice Guidelines. It begins with an introduction stating the purpose and motivation for developing worldwide guidelines. It describes the guideline development process, including the composition of the guidelines committee. The document then provides definitions of hypertension based on blood pressure readings and classifications of blood pressure levels. It outlines recommendations for diagnosing hypertension through office blood pressure measurements and details proper measurement techniques. The summary highlights the key goals and approaches of the 2020 ISH Global Hypertension Practice Guidelines.
Pulmonary hypertension is defined as a mean pulmonary artery pressure greater than 25 mmHg. It is classified based on whether the elevation in pressure is pre-capillary or post-capillary. The pathogenesis involves various changes in the pulmonary vasculature that lead to increased pulmonary vascular resistance. Diagnosis involves symptoms, physical exam findings, imaging like echocardiogram, and right heart catheterization. Treatment aims to improve hemodynamics and symptoms through pulmonary vasodilators and diuretics. Anesthetic management of pulmonary hypertension patients requires optimizing preload, afterload, and contractility while avoiding triggers of pulmonary hypertension. Close monitoring is important both intraoperatively and postoperatively.
The document discusses guidelines from the 2015 ESC on the diagnosis and management of pericardial diseases. It provides an overview of key sections and recommendations from the guidelines. The sections discussed include epidemiology of pericardial diseases, aetiology of pericardial diseases, acute pericarditis, and recurrent pericarditis. It emphasizes the need to gather more specific epidemiological data from different geographical areas to better understand differing aetiologies. It also notes that the most frequent cause of pericarditis (idiopathy) is not fully understood and warrants further examination.
1) Pulmonary hypertension (PH) is defined as elevated pulmonary artery pressure, while pulmonary arterial hypertension (PAH) is a subtype caused by constriction and remodeling of small pulmonary arteries.
2) PAH is a progressive disease that involves proliferation of cells in the pulmonary arteries leading to increased pulmonary vascular resistance and right heart failure if left untreated.
3) The document reviews classification of PH, diagnostic testing and evaluation algorithms, goals of treatment, and approved therapies for PAH.
This document provides guidelines for the management of hypertension from the International Society of Hypertension (ISH). It aims to provide evidence-based recommendations that are practical for both low and high resource settings.
The guidelines were developed by extracting evidence from recently published guidelines and tailoring them to be concise and easy to use globally. They define hypertension as a blood pressure over 140/90 mmHg based on office measurements. The guidelines recommend lifestyle modifications and pharmacological treatment for confirmed hypertension. They also provide guidance on diagnostic tests, risk factors, target organ damage, comorbidities and special circumstances like pregnancy. The goal is to reduce the global burden of raised blood pressure through practical standards of care.
Newest 2020 ISH global hypertension practice guidelinesChanRyan4
This document provides an introduction and table of contents for guidelines on the management of hypertension. It aims to provide evidence-based recommendations tailored for both high and low resource settings. The guidelines were developed by extracting content from recently published extensively reviewed guidelines. It recognizes that optimal care may not always be possible, so essential standards of care are provided that recognize limitations in clinical evidence and resources. The motivation for developing these guidelines is the large global burden of raised blood pressure, with awareness, treatment and control rates especially low in low- and middle-income countries.
This document provides guidelines for the management of hypertension from the International Society of Hypertension (ISH). It aims to extract evidence-based recommendations from major guidelines and tailor them for both high and low resource settings. Section 1 introduces the context and purpose of the guidelines, which is to reduce the global burden of raised blood pressure. It notes that while over 1 billion people have hypertension, rates of awareness, treatment and control remain low, especially in low- and middle-income countries. The guidelines thus seek to provide practical, globally-applicable recommendations to improve hypertension management worldwide.
1) A 55-year-old woman presented with shortness of breath and was found to have right ventricular hypertrophy on ECG. Echocardiogram showed an atrial septal defect with pulmonary hypertension.
2) A 35-year-old woman with shortness of breath for 3 years was found to have mitral stenosis and pulmonary hypertension on echocardiogram.
3) A pregnant 25-year-old woman had severe pulmonary hypertension found on echocardiogram.
Translational Updates in HF: Evolving Science for the Practicing ClinicianDuke Heart
This document discusses recent translational updates in heart failure (HF) for clinicians. It begins by defining pulmonary hypertension (PH) and its subtypes. It then reviews current PAH therapies and recent clinical trials. Precision medicine approaches in PAH are also discussed. A phase 2 trial of the drug sotatercept in PAH is summarized, which aims to treat PAH by targeting transforming growth factor-beta signaling. The document concludes by noting treatment of PH is guided by diagnosis and current PAH treatment focuses on combination therapy and achieving low risk status, while challenges include treating non-Group 1 PH and patients who change PH groups.
The document describes an acute respiratory distress syndrome (ARDS) care plan. It defines ARDS as hypoxemia and bilateral lung opacities caused by diffuse alveolar damage. The care plan outlines the clinical signs of ARDS including respiratory distress, hypoxemia on blood gases, and bilateral opacities on chest x-ray. The therapeutic goals are supportive care to prevent complications, manage hypoxemia, and decrease oxygen consumption. Monitoring parameters include daily assessment of oxygenation using the PF ratio and ventilator settings. The care plan recommends a lung protective ventilation strategy using low tidal volumes, sedation, conservative fluid management, and treating any infections.
This document presents the 2018 guidelines for the management of arterial hypertension from the European Society of Cardiology and the European Society of Hypertension. It was developed by a task force of experts and provides an updated definition of hypertension, classifications of blood pressure, prevalence and risks associated with elevated blood pressure, as well as guidelines for blood pressure measurement, evaluation of hypertension-mediated organ damage, and treatment strategies. The guidelines emphasize the importance of assessing total cardiovascular risk and refining risk based on the presence of organ damage in hypertensive patients.
Pulmonary hypertension (PH) is defined as a mean pulmonary arterial pressure >20 mm Hg at rest. It can be caused by various conditions and is classified into 5 groups. Symptoms include dyspnea, fatigue, edema and syncope. Diagnosis involves ECG, echocardiogram, cardiac MRI and right heart catheterization. Treatment includes diuretics, oxygen therapy, calcium channel blockers, endothelin receptor antagonists, PDE5 inhibitors, prostacyclin analogs and lung transplantation in severe cases. Portopulmonary hypertension (POPH) occurs in 5% of cirrhosis patients and is treated similarly to PH but CCBs are generally avoided due to risk of worsening symptoms.
This document discusses pulmonary hypertension (PH), including its definition, classification, pathophysiology, clinical evaluation, diagnostic studies, and treatment. PH is defined as a mean pulmonary artery pressure greater than 25 mmHg and is classified into 5 groups. The pathophysiology involves sustained vasoconstriction, vascular remodeling, in situ thrombosis, and increased arterial wall thickness. Clinical features are often nonspecific, so diagnosis can be delayed over 2 years on average from symptom onset. Physical examination may reveal signs of right heart failure.
Advances in understanding PAH include genetic discoveries that identify targets for new treatments and risk assessment tools that help guide clinical decisions. Diagnosis has improved with a comprehensive clinical classification of PH and case illustrations. Treatment evidence has advanced through randomized trials of new drugs and procedures like BPA for CTEPH, while composite endpoints in trials require careful interpretation. Updated 2018 algorithms guide the treatment of PAH and CTEPH.
1) HFpEF is the most common form of heart failure, affecting over 70% of heart failure patients over age 65. It is associated with substantial morbidity and mortality.
2) HFpEF is challenging to diagnose because ejection fraction is normal and cardiac congestion is difficult to evaluate non-invasively. It is defined hemodynamically as a clinical syndrome associated with a lack of capacity of the heart to pump blood adequately without elevated cardiac filling pressures.
3) There is currently no effective pharmacological treatment for HFpEF. Treatment focuses on controlling congestion through diuretics, managing comorbidities, and promoting exercise. Future efforts to better characterize HFpEF phenotypes may allow individualized therapies
Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary arterial resistance leading to right heart failure. PAH can be idiopathic, familial due to genetic mutations, or associated with other conditions. Symptoms include breathlessness, but are nonspecific, often leading to underdiagnosis. Diagnosis requires right heart catheterization to measure blood pressure and rule out other causes. Recent treatment advances have improved prognosis, but lung transplantation remains an option for severe cases.
This document summarizes pulmonary hypertension and its management. It discusses the pulmonary circulation and pressures, types and classification of pulmonary hypertension, pathogenesis involving various molecular pathways, clinical diagnosis using echocardiography, right heart catheterization, and treatment goals and strategies. The main treatment approaches discussed are calcium channel blockers, prostanoids, endothelin receptor antagonists, phosphodiesterase inhibitors, and soluble guanylate cyclase stimulators. The goals of treatment are to palliate symptoms, improve exercise tolerance and right ventricular function, and strive to improve survival rates.
THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...Nursing Mastery
Title: Unlocking the Wonders of the Special Senses: Sight, Sound, Smell, Taste, and Balance
Introduction:
Welcome to our captivating SlideShare presentation on the Special Senses, where we delve into the extraordinary capabilities that allow us to perceive and interact with the world around us. Join us on a sensory journey as we explore the intricate structures and functions of sight, sound, smell, taste, and balance.
The special senses are our primary means of experiencing and interpreting the environment, each sense providing unique and vital information that shapes our perceptions and responses. These senses are facilitated by highly specialized organs and complex neural pathways, enabling us to see a vibrant sunset, hear a symphony, savor a delicious meal, detect a fragrant flower, and maintain our equilibrium.
In this presentation, we will:
Visual System (Sight): Dive into the anatomy and physiology of the eye, exploring how light is converted into electrical signals and processed by the brain to create the images we see. Understand common vision disorders and the mechanisms behind corrective measures like glasses and contact lenses.
Auditory System (Hearing): Examine the structures of the ear and the process of sound wave transduction, from the outer ear to the cochlea and auditory nerve. Learn about hearing loss, auditory processing, and the advances in hearing aid technology.
Olfactory System (Smell): Discover the olfactory receptors and pathways that enable the detection of thousands of different odors. Explore the connection between smell and memory and the impact of olfactory disorders on quality of life.
Gustatory System (Taste): Uncover the taste buds and the five basic tastes – sweet, salty, sour, bitter, and umami. Delve into the interplay between taste and smell and the factors influencing our food preferences and eating habits.
Vestibular System (Balance): Investigate the inner ear structures responsible for balance and spatial orientation. Understand how the vestibular system helps maintain posture and coordination, and explore common vestibular disorders and their effects.
Through engaging visuals, interactive diagrams, and insightful explanations, we aim to illuminate the complexities of the special senses and their profound impact on our daily lives. Whether you're a student, educator, or simply curious about how we perceive the world, this presentation will provide valuable insights into the remarkable capabilities of the human sensory system.
Join us as we unlock the wonders of the special senses and gain a deeper appreciation for the intricate mechanisms that allow us to experience the richness of our environment.
Cyclothymia Test: Diagnosing, Symptoms, Treatment, and Impact | The Lifescien...The Lifesciences Magazine
The cyclothymia test is a pivotal tool in the diagnostic process. It helps clinicians assess the presence and severity of symptoms associated with cyclothymia.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
2024 Media Preferences of Older Adults: Consumer Survey and Marketing Implica...Media Logic
When it comes to creating marketing strategies that target older adults, it is crucial to have insight into their media habits and preferences. Understanding how older adults consume and use media is key to creating acquisition and retention strategies. We recently conducted our seventh annual survey to gain insight into the media preferences of older adults in 2024. Here are the survey responses and marketing implications that stood out to us.
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
Prepared by Prof. BLESSY THOMAS, VICE PRINCIPAL, FNCON, SPN.
Emphysema is a disease condition of respiratory system.
Emphysema is an abnormal permanent enlargement of the air spaces distal to terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.
Emphysema of lung is defined as hyper inflation of the lung ais spaces due to obstruction of non respiratory bronchioles as due to loss of elasticity of alveoli.
It is a type of chronic obstructive
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It is a progressive disease of lungs.
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We look into the evolution of health informatics and its applications in the healthcare industry.
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Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Research, Monitoring and Evaluation, in Public Healthaghedogodday
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
Health Tech Market Intelligence Prelim Questions -Gokul Rangarajan
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
1. CẬP NHẬT KHUYẾN CÁO ESC 2022
CHẨN ĐOÁN VÀ ĐIỀU TRỊ TĂNG ÁP MẠCH MÁU PHỔI
BS. Nguyễn Văn Hiếu
2. NỘI DUNG
• 114 trang khuyến cáo, lần thứ 4 (2004 – 2009 – 2015 -
2022), bởi Hội Tim mạch châu Âu ESC và Hội Hô hấp châu
Âu (ERS).
• Cập nhật về chẩn đoán và phân loại PH, nhấn mạnh PAH
và CTEPH
• Cập nhật về điều trị
3. Tuần hoàn hệ thống:
• Tăng huyết áp: Tăng áp lực và sức cản
Động mạch hệ thống.
• Chẩn đoán xác định dựa vào đo huyết áp
ĐM cánh tay.
• Gánh nặng: Tim trái, não, thận, mắt,
ĐMC…
Tuần hoàn phổi:
• Tăng áp phổi (tăng áp mạch máu phổi/
tang áp lực mạch phổi - PH): Tăng áp lực và
sức cản mạch máu phổi, gồm Động mạch
phổi và Tĩnh mạch phổi.
• Chẩn đoán dựa vào các thông số Thông
tim phải.
• Gánh nặng: Tim phải, phổi.
HIỂU CƠ BẢN VỀ TĂNG ÁP PHỔI
4. TĂNG ÁP PHỔI
• Tăng áp phổi hay Tăng áp mạch máu phổi (Pulmonary hypertension)
• Chẩn đoán xác định: Dựa trên thông tim phải, áp lực ĐMP trung bình > 20
mmHg.
• Phân nhóm: 5 nhóm
• Đánh giá mức độ nặng: Dựa vào đánh giá lâm sàng (Suy tim, WHO –FC, Test
6 phút đi bộ), cận lâm sàng (siêu âm tim, ProBNP…), thông tim phải.
• Điều trị: Bệnh được mô tả lần đầu vào năm 1891, tuy nhiên đến năm 1995
mới lần đầu tiên có thuốc điều trị (epoprostenol). Hiện tại việc điều trị còn
nhiều thách thức. Các thuốc điều trị chủ yếu tập trung vào PAH nhóm 1 và
nhóm 4.
5. PHÂN BIỆT TĂNG ÁP PHỔI (PH) VÀ TĂNG ÁP
ĐỘNG MẠCH PHỔI (PAH)
- Tăng áp phổi (Pulmonary hypertension): Còn gọi là Tăng áp mạch máu
phổi. Được định nghĩa khi áp lực ĐMP trung bình (mPAP) > 20 mmHg
(trên thông tim phải).
- Tăng áp động mạch phổi (Pulmonary aterial hypertension): Còn gọi là
Tăng áp phổi tiền mao mạch (pre-capillary pulmonary hypertension), là
PH nhóm 1. Được định nghĩa khi:
• Áp lực ĐMP trung bình (mPAP) > 20 mmHg
• Sức cản phổi tăng (RVR) > 2 WU
• Áp lực mao mạch phổi bít bình thường (PAWP) ≤ 15 mmHg
15. Loại Mô tả a
WHO-FC I Bệnh nhân có PH nhưng không dẫn đến hạn chế hoạt động thể chất. Hoạt động thể chất bình
thường không gây khó thở quá mức hoặc mệt mỏi, đau ngực hoặc gần ngất
WHO-FC II Bệnh nhân có PH dẫn đến hạn chế nhẹ hoạt động thể chất. BN thoải mái khi nghỉ ngơi. Hoạt
động thể chất thông thường gây khó thở hoặc mệt mỏi quá mức, đau ngực hoặc gần ngất
WHO-FC III Bệnh nhân có PH dẫn đến hạn chế rõ rệt các hoạt động thể chất. BN thoải mái khi nghỉ ngơi. Ít
hoạt động hơn bình thường do khó thở hoặc mệt mỏi quá mức, đau ngực hoặc gần như ngất
xỉu
WHO-FC IV Bệnh nhân PH không có khả năng thực hiện bất kỳ hoạt động thể chất nào mà không có triệu
chứng. Những bệnh nhân này có dấu hiệu của HF bên phải. Khó thở và / hoặc mệt mỏi thậm
chí có thể xuất hiện khi nghỉ ngơi. Sự khó chịu tăng lên bởi bất kỳ hoạt động thể chất nào
Phân loại của Tổ chức Y tế Thế giới về tình trạng chức năng
của bệnh nhân tăng áp phổi (WHO-FC)
20. Các nhóm thuốc điều trị
Trước năm 1995 không có thuốc điều trị đặc hiệu cho tăng áp động mạch phổi
(PAH).
Hiện tại đã có bốn nhóm thuốc được chấp nhận trong điều trị PAH (PH nhóm 1)
bao gồm:
(1) Các thuốc giống prostacyclin: Epoprostenol iv; Treprostinil các dạng tiêm và
uống; Iloprost dạng khí dung.
(2) Thuốc đối kháng thụ thể endothelin: Bosentan, Macitentan, Ambrisentan.
(3)Thuốc ức chế phosphodiesterase – 5: Sildenafil, Tadalafil.
(4) Thuốc kích thích trực tiếp guanin cyclase hòa tan: Riociguat.
Các nhóm PH 2,3,4: Hiệu quả các thuốc điều trị còn hạn chế. Riociguat có chỉ
định sử dụng ở bệnh nhân CTEPH (PH nhóm 4) không có chỉ định phẫu thuật.
48. ĐIỀU TRỊ KÈM THEO
• Điều trị lợi Œểu, chống đông.
• Điều trị thiếu máu và bù sắt.
• Tập thể dục phục hồi chức năng thể lực
• Mang thai và tránh thai: Tránh mang thai
• Gây mê/tê và Các phẫu thuật có kế hoạch
• Tiêm phòng vacxin cúm, phế cầu, COVID-19
• Du lịch độ cao
• Hỗ trợ tâm lý
• Tư vấn di truyền với các trường hợp có yếu tố di truyền
• Gắn kết và tuân thủ điều trị
49. Kết luận
• Tăng áp phổi: Chiếm khoảng 1% dân số. Gặp ở mọi lứa tuổi và
giới tính
• Nguyên nhân thường gặp: Do bệnh lý tim trái và Do bệnh lý phổi.
• Chẩn đoán xác định: Dựa vào các thông số áp lực và sức cản
mạch phổi trên Thông tim phải
• Phân loại: 5 nhóm (group)
• Đánh giá nguy cơ: Dựa trên lâm sàng (WHO FC, triệu chứng lâm
sàng) và cận lâm sàng (siêu âm tim, ProBNP, MRI, Thông tim P),
thang điểm Reveal.
• Điều trị: Hiện còn nhiều thách thức. Cần phối hợp đa chuyên
khoa theo Nhóm bệnh.