Portal hypertention
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Portal hypertension is defined as a portal venous pressure above 10 mmHg. It can be caused by pre-hepatic issues like blockages in the portal vein or post-hepatic issues like Budd-Chiari syndrome. Common complications include variceal bleeding, ascites, and hepatic encephalopathy. Diagnosis involves clinical features, endoscopy, and imaging. Treatment options range from medications and endoscopic procedures to TIPS, shunts, and liver transplantation.
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Portal hypertension
This document discusses portal hypertension, including its causes, symptoms, and treatment. Potential collaterals in portal hypertension are hypertrophied and hyperplastic due to angiogenic factors, not just increased pressure. Complications of portal hypertension include variceal hemorrhage, ascites, renal dysfunction, and hepatic encephalopathy. Cirrhosis is the most common cause worldwide. Treatment depends on variceal size, with band ligation for varices over 5mm to prevent bleeding. Drugs can be used initially for active bleeding but TIPS or surgery may be needed for severe cases.
Portal Hypertension
Portal hypertension occurs when scar tissue from liver injuries disrupts blood flow, increasing pressure in the main and portal veins and diverting blood away from the liver. The most common cause is cirrhosis, but it can also be caused by blood clots, fatty liver disease, hepatitis, or schistosomiasis. Symptoms include gastrointestinal bleeding, abdominal fluid buildup, and varicose veins. Diagnosis involves medical history, lab tests, and imaging exams. Treatment focuses on medications and procedures to reduce blood pressure such as sclerotherapy and TIPS or DSRS shunt surgery in severe cases. Lifestyle changes like quitting drinking and smoking can help prevent portal hypertension.
Abernathy syndrome
Abernethy malformation is defined as congenital diversion of portal blood away from the liver by either end-to-side or side-to-side shunt
Dyspnea, Diffuse Alveolar Hemorrhage, Pulmonary Embolism, Respiratory Failure
Type 1 respiratory failure is defined as hypoxemia without hypercapnia, caused by conditions that impair oxygenation like pneumonia. Type 2 involves both hypoxemia and hypercapnia due to inadequate ventilation from issues like COPD.
Pulmonary embolism occurs when a blood clot lodges in the lungs, impairing gas exchange. Risk factors include leg injuries and surgeries. Diffuse alveolar hemorrhage results from widespread damage to small lung vessels, leading to blood in the alveoli. Causes include autoimmune disorders and infections. Pneumonia has multiple causes and presentations depending on patient factors. Proper diagnosis and treatment of underlying conditions are important for managing respiratory failure.
Hepato pulmonary syndrome
Hepatopulmonary syndrome involves liver disease, impaired oxygenation, and intrapulmonary vascular abnormalities called intrapulmonary vascular dilatations. These dilatations range from 15-160 microns and cause ventilation-perfusion mismatching and oxygen diffusion limitations, leading to hypoxemia. Clinical features include dyspnea, cyanosis, and worsening in the upright position. Liver transplantation can resolve the syndrome by correcting the underlying liver disease.
Cardiogenic pe
Cardiogenic pulmonary edema is caused by increased hydrostatic pressure in the pulmonary veins due to cardiac dysfunction from various etiologies like mitral stenosis, congestive heart failure, cardiomyopathy, and myocardial infarction. Patients typically present with sudden shortness of breath, anxiety, coughing up pink frothy sputum, and other symptoms. Diagnosis involves blood tests, electrocardiogram, chest x-ray, and other exams. Treatment focuses on ventilatory support, reducing preload and afterload on the heart, and providing inotropic support. Prognosis varies greatly case by case.
Hd initiation protocol
This document outlines protocols for initiating emergency and regular hemodialysis (HDx). Emergency HDx is indicated for severe volume overload, uremia, hyperkalemia, or academia. Regular HDx is initiated for end-stage renal disease (ESRD) if uremic symptoms are present with a blood urea over 200 mg/dl, refractory volume overload, eGFR below 15 ml/min/1.73m2, or creatinine over 8 mg/dl (6 mg/dl for diabetics). For acute kidney injury (AKI), regular HDx begins with similar uremic symptoms and refractory volume overload.
Porto pulmonary hypertension
Porto-pulmonary hypertension (PPHTN) occurs when a patient has both portal hypertension and pulmonary arterial hypertension without another cause for PAH. It is characterized by a mean pulmonary artery pressure over 25 mmHg and pulmonary capillary wedge pressure under 15 mmHg. The cause is unknown but factors linked to portal hypertension like serotonin have been detected at higher levels in patients. Epoprostenol, sildenafil, bosentan, and ambrisentan have all shown benefits in treating PPHTN by improving hemodynamics and exercise tolerance.
Recommended
Portal hypertension
This document discusses portal hypertension, including its causes, symptoms, and treatment. Potential collaterals in portal hypertension are hypertrophied and hyperplastic due to angiogenic factors, not just increased pressure. Complications of portal hypertension include variceal hemorrhage, ascites, renal dysfunction, and hepatic encephalopathy. Cirrhosis is the most common cause worldwide. Treatment depends on variceal size, with band ligation for varices over 5mm to prevent bleeding. Drugs can be used initially for active bleeding but TIPS or surgery may be needed for severe cases.
Portal Hypertension
Portal hypertension occurs when scar tissue from liver injuries disrupts blood flow, increasing pressure in the main and portal veins and diverting blood away from the liver. The most common cause is cirrhosis, but it can also be caused by blood clots, fatty liver disease, hepatitis, or schistosomiasis. Symptoms include gastrointestinal bleeding, abdominal fluid buildup, and varicose veins. Diagnosis involves medical history, lab tests, and imaging exams. Treatment focuses on medications and procedures to reduce blood pressure such as sclerotherapy and TIPS or DSRS shunt surgery in severe cases. Lifestyle changes like quitting drinking and smoking can help prevent portal hypertension.
Abernathy syndrome
Abernethy malformation is defined as congenital diversion of portal blood away from the liver by either end-to-side or side-to-side shunt
Dyspnea, Diffuse Alveolar Hemorrhage, Pulmonary Embolism, Respiratory Failure
Type 1 respiratory failure is defined as hypoxemia without hypercapnia, caused by conditions that impair oxygenation like pneumonia. Type 2 involves both hypoxemia and hypercapnia due to inadequate ventilation from issues like COPD.
Pulmonary embolism occurs when a blood clot lodges in the lungs, impairing gas exchange. Risk factors include leg injuries and surgeries. Diffuse alveolar hemorrhage results from widespread damage to small lung vessels, leading to blood in the alveoli. Causes include autoimmune disorders and infections. Pneumonia has multiple causes and presentations depending on patient factors. Proper diagnosis and treatment of underlying conditions are important for managing respiratory failure.
Hepato pulmonary syndrome
Hepatopulmonary syndrome involves liver disease, impaired oxygenation, and intrapulmonary vascular abnormalities called intrapulmonary vascular dilatations. These dilatations range from 15-160 microns and cause ventilation-perfusion mismatching and oxygen diffusion limitations, leading to hypoxemia. Clinical features include dyspnea, cyanosis, and worsening in the upright position. Liver transplantation can resolve the syndrome by correcting the underlying liver disease.
Cardiogenic pe
Cardiogenic pulmonary edema is caused by increased hydrostatic pressure in the pulmonary veins due to cardiac dysfunction from various etiologies like mitral stenosis, congestive heart failure, cardiomyopathy, and myocardial infarction. Patients typically present with sudden shortness of breath, anxiety, coughing up pink frothy sputum, and other symptoms. Diagnosis involves blood tests, electrocardiogram, chest x-ray, and other exams. Treatment focuses on ventilatory support, reducing preload and afterload on the heart, and providing inotropic support. Prognosis varies greatly case by case.
Hd initiation protocol
This document outlines protocols for initiating emergency and regular hemodialysis (HDx). Emergency HDx is indicated for severe volume overload, uremia, hyperkalemia, or academia. Regular HDx is initiated for end-stage renal disease (ESRD) if uremic symptoms are present with a blood urea over 200 mg/dl, refractory volume overload, eGFR below 15 ml/min/1.73m2, or creatinine over 8 mg/dl (6 mg/dl for diabetics). For acute kidney injury (AKI), regular HDx begins with similar uremic symptoms and refractory volume overload.
Porto pulmonary hypertension
Porto-pulmonary hypertension (PPHTN) occurs when a patient has both portal hypertension and pulmonary arterial hypertension without another cause for PAH. It is characterized by a mean pulmonary artery pressure over 25 mmHg and pulmonary capillary wedge pressure under 15 mmHg. The cause is unknown but factors linked to portal hypertension like serotonin have been detected at higher levels in patients. Epoprostenol, sildenafil, bosentan, and ambrisentan have all shown benefits in treating PPHTN by improving hemodynamics and exercise tolerance.
Cor pulmonale 1
Cor pulmonale is right heart failure caused by chronic pulmonary hypertension. It is often caused by lung diseases like COPD and asthma, or pulmonary vascular diseases like pulmonary embolism. Symptoms include dyspnea, fatigue and syncope. Signs include elevated jugular venous pressure, heart murmurs, hepatomegaly and edema. Investigations show signs of pulmonary hypertension and right heart strain on tests like chest x-ray and ECG. Management focuses on treating the underlying cause, respiratory failure with oxygen, and cardiac failure with diuretics. The prognosis is generally poor with 50% of patients dying within 5 years.
Portal hypertension
Portal hypertension can be caused by conditions that block the portal vein (precirrhotic) or damage the liver (cirrhotic). It leads to complications like ascites, esophageal varices, and bleeding. Symptoms include abdominal swelling and pain, bleeding, and fatigue. Treatment focuses on reducing portal pressure through dietary changes, diuretics, banding or sclerotherapy of varices, transjugular intrahepatic portosystemic shunting (TIPS), or surgery in severe cases.
8.cor pulmonale
Cor pulmonale is enlargement, dilatation, hypertrophy or failure of the right ventricle in response to increased load from pulmonary hypertension caused by lung or pulmonary vessel disorders. It can be acute or chronic. Chronic cor pulmonale causes thickening of the right ventricular walls, while acute cor pulmonale causes dilation and wall thinning. Causes include chronic obstructive pulmonary disease, diffuse pulmonary fibrosis, pulmonary thromboembolism, primary pulmonary hypertension, and extensive pulmonary arteritis.
Hepatopulmonary syndrome by Albin Joseph
Hepatopulmonary syndrome (HPS) is characterized by liver disease, intrapulmonary vascular dilatations, and impaired oxygenation. It has a prevalence of 4-47% in adults with liver disease. The pathophysiology involves dilated pulmonary capillaries leading to ventilation-perfusion mismatching. Clinical features include cyanosis, clubbing, and low oxygen saturation. Diagnosis involves abnormal arterial blood gases and bubble echocardiography demonstrating intrapulmonary shunting. While liver transplantation effectively treats HPS, the case presentation describes a patient's complex postoperative course including nitric oxide supplementation and tracheostomy who ultimately was successfully decannulated.
Recent advance management of portal hypertension
This document discusses recent advances in the management of portal hypertension. It begins by defining portal hypertension and explaining how hepatic venous pressure gradient (HVPG) is used to measure it. HVPG thresholds of 10 mmHg and above indicate clinically significant portal hypertension. The document then discusses the pathophysiology of portal hypertension, focusing on the roles of hepatic stellate cells, angiogenesis, nitric oxide, and other vasoactive substances. It also summarizes evidence on the uses of beta-blockers, statins, and other drugs to reduce portal pressure. Several novel drug targets for managing portal hypertension are mentioned as areas of ongoing research.
Hepato pulmonary syndrome
Hepato-Pulmonary Syndrome (HPS) is characterized by liver disease, abnormal gas exchange, and vascular dilations in the lungs. It is caused by an imbalance of vasodilator and vasoconstrictor agents due to overproduction of vasodilators from injured liver tissue. This leads to widespread pulmonary vasodilatation and right-to-left shunting of blood, causing hypoxemia. HPS is diagnosed based on evidence of liver disease, hypoxemia that improves with 100% oxygen, and findings of intrapulmonary vasodilatations. Mild cases are monitored while severe cases receive long-term oxygen supplementation and possibly liver transplantation.
Portal hypertension by kiran maindale
Portal hypertension occurs when blood pressure in the portal vein system, which drains blood from the gastrointestinal tract to the liver, increases above normal levels. It is defined as a hepatic venous pressure gradient greater than 15 mmHg. Two key factors that contribute to portal hypertension are increased vascular resistance and increased blood flow. Investigation may include blood tests and imaging of the liver, portal system, and varices. Complications include variceal bleeding, ascites, and hepatic encephalopathy. Treatment depends on severity but may involve medication, endoscopic procedures, transjugular intrahepatic portosystemic shunt placement, or surgical shunting of blood flow to reduce portal pressure.
Pulmonary edema & cardiogenic apo
Acute pulmonary edema refers to excess fluid in the lungs that can have cardiogenic or non-cardiogenic causes. Cardiogenic pulmonary edema is often due to left ventricular dysfunction that leads to increased pulmonary capillary pressure. Common causes of left ventricular dysfunction include congestive heart failure, myocardial infarction, cardiomyopathy, and valvular diseases. Pulmonary edema progresses through three stages as excess fluid builds up first in small blood vessels then the lung interstitium and alveoli, impairing gas exchange.
thromboembolism
Thromboembolism refers to the blocking of blood vessels by particles that have broken away from clots in the body. It is common in patients with cardiac disease or impaired circulation. Intracardiac thrombi, which can be detected by echocardiogram, are especially common in patients with atrial fibrillation. Pulmonary embolism occurs when a thrombus breaks off and travels to the lung, often from a deep vein thrombosis. It can be treated with anticoagulants or thrombolytics. Pericardial effusion involves a buildup of fluid in the sac around the heart, which can lead to cardiac tamponade if pressure increases and compresses the heart.
Cor pulmonale
Cor pulmonale, or right heart failure caused by pulmonary or thoracic disease, can result from pulmonary arterial hypertension (PAH) due to conditions that obstruct the pulmonary vasculature. Common causes of PAH include heartworm disease, pulmonary thromboembolism from conditions causing blood stasis or hypercoagulability, and chronic lung diseases. Physical exam may reveal murmurs, respiratory distress, and signs of congestion. Diagnosis involves detecting abnormal gas exchange on bloodwork, radiographic evidence of lung disease or right heart enlargement, and ECG changes reflective of right heart strain. However, diagnosing the underlying cause like pulmonary thromboembolism can be challenging as exams and tests may be normal in some
Pulmonary edema
Pulmonary edema is the accumulation of fluid in the lungs, which makes breathing difficult. It occurs when fluid leaks into the tiny air sacs in the lungs called alveoli. This fluid buildup is usually due to heart failure or conditions that increase blood pressure in the lungs. Common symptoms include shortness of breath, cough, and wheezing. Diagnosis involves listening to the chest, chest x-rays, and echocardiograms. Treatment focuses on reducing fluid buildup through diuretics, oxygen therapy, and treating the underlying cause.
7 cor pulmonale
Cor Pulmonale, also known as pulmonary heart disease, is caused by high blood pressure in the lungs secondary to diseases affecting the lungs, chest wall, or pulmonary vasculature. It is characterized by hypertrophy and dilation of the right ventricle of the heart in response to the elevated pulmonary pressures. The main symptoms include cough, sputum production, shortness of breath, fatigue, and leg swelling. Diagnosis involves assessing the patient's medical history along with tests such as chest x-rays, electrocardiograms, echocardiograms, and blood gas analysis. Treatment focuses on controlling infections, improving oxygen levels, managing heart failure, and preventing complications through patient monitoring and education.
Portal Hypertension
The portal vein is formed by the superior mesenteric and splenic veins. It drains blood from the intestines, pancreas, colon and rectum. Blood from the portal and hepatic arteries mixes in the liver sinusoids before draining into the hepatic vein and inferior vena cava. Portal hypertension occurs when pressure increases due to increased resistance in the liver from cirrhosis and increased blood flow. It can cause ascites, variceal bleeding, and other complications.
Pulmonary hypertension
The pulmonary vascular circuit has low resistance and carries 70ml of blood normally. Blood flow is normally higher in the lung bases than apices due to gravity. The pulmonary arteries have a small diameter of 3mm or less in the upper intercostal spaces. Pulmonary hypertension is defined as a sustained elevation of pulmonary arterial pressure over 25mmHg at rest or 30mmHg during exercise, with normal pulmonary capillary wedge pressure and left ventricular end-diastolic pressure. Signs on chest X-ray include enlarged pulmonary arteries, loss of peripheral vessel markings, and enlargement of the right side of the heart in advanced disease.
Pulmonary Edema - Case Presentation
This document presents the case of a 74-year-old male who presented to the emergency department with acute exacerbation of breathlessness, cough with expectoration, and chest pain. On examination, he had tachypnea, hypoxemia, coarse crepitations on lung auscultation, tachycardia, and elevated blood pressure. Investigations revealed anemia and echocardiography showed left ventricular hypertrophy, systolic dysfunction, and diastolic dysfunction. He was diagnosed with acute left heart failure with pulmonary edema and treated with oxygen, diuretics, antibiotics, vasodilators, and transferred to the ICU.
Pulmonary edema roge ppt (1)
Pulmonary edema is the accumulation of fluid in the interstitium and alveoli of the lungs. It can be caused by conditions that increase hydrostatic pressure or decrease oncotic pressure leading to fluid movement from capillaries into lung tissue. The main types are cardiogenic pulmonary edema from heart failure or damage and non-cardiogenic edema from toxic inhalation or infections. Symptoms range from shortness of breath to cough with frothy sputum. Diagnosis involves physical exam, chest x-ray, and tests like ABG analysis and echocardiogram. Treatment focuses on oxygen therapy, positioning, diuretics, and vasodilators to reduce pulmonary congestion.
Pulmonary HTN
Pulmonary hypertension (PH) is defined as a mean pulmonary artery pressure ≥25 mmHg at rest. It is characterized by elevated pulmonary pressures and secondary right ventricular failure. PH can be caused by genetic mutations, pulmonary arterial hypertension (PAH) second hits like congenital heart disease or HIV, or pulmonary venous hypertension second hits like COPD or heart failure. Symptoms include dyspnea, chest pain, syncope, and edema. Diagnostic testing includes echocardiogram, right heart catheterization, and blood tests. Treatment involves diuretics, oxygen, anticoagulation, and advanced therapies for PAH like vasodilators or lung transplantation.
Fwd: Bambury lecture on venous and lymphatic disorders of the limb
---------- Forwarded message ----------
From: Henning L. Stokmo <helangen@gmail.com>
Date: 2009/2/12
Subject: Bambury lecture on venous and lymphatic disorders of the limb
To: ucdgrad09@gmail.com
Upper GI bleeding & portal hypertension in Children
This document discusses signs and symptoms of gastrointestinal bleeding, including melena, haematemesis, and haematochezia. It covers evaluation, treatment, and management of variceal bleeding including pharmacologic therapies, endoscopic procedures like band ligation and sclerotherapy, and surgical options like shunts and transplantation.
Pulmonary edema
Pulmonary edema is a condition caused by excessive fluid in the lungs, making it difficult to breathe. There are two main types: cardiogenic, caused by issues with the heart like weakened pumping from heart disease or damage, and non-cardiogenic, caused by things like drug use, smoke inhalation, or viral infections which damage the lungs. Complications can include swelling in the legs and abdomen. Treatment focuses on removing excess fluid with diuretics, relieving symptoms, and addressing the underlying cause.
Portal hypertension
Portal hypertension occurs when there is increased blood pressure in the portal vein system due to an obstruction of blood flow. This causes blood to flow through alternative veins and can lead to the development of varices and risk of bleeding. Portal hypertension has prehepatic, intrahepatic, and posthepatic etiologies and can be acute or chronic. Clinical features include variceal bleeding, ascites, and signs of liver dysfunction. Diagnosis involves ultrasound, CT, and endoscopy. Treatment includes nonselective beta blockers, transjugular intrahepatic portosystemic shunts, and surgery to shunt blood flow. Complications are bleeding varices, hepatorenal syndrome, and infections.
PORTAL HYPERTENSION.pptx
This document discusses portal hypertension, beginning with definitions and anatomy. It then covers the causes of portal hypertension including presinusoidal, sinusoidal, and postsinusoidal etiologies. The main clinical manifestations are gastrointestinal bleeding, splenomegaly, and encephalopathy. Diagnosis involves blood tests, imaging, and endoscopy. Treatment of acute bleeding involves fluid resuscitation, antibiotics, vasoactive drugs, endoscopic therapies, and shunt procedures if bleeding persists.
More Related Content
What's hot
Cor pulmonale 1
Cor pulmonale is right heart failure caused by chronic pulmonary hypertension. It is often caused by lung diseases like COPD and asthma, or pulmonary vascular diseases like pulmonary embolism. Symptoms include dyspnea, fatigue and syncope. Signs include elevated jugular venous pressure, heart murmurs, hepatomegaly and edema. Investigations show signs of pulmonary hypertension and right heart strain on tests like chest x-ray and ECG. Management focuses on treating the underlying cause, respiratory failure with oxygen, and cardiac failure with diuretics. The prognosis is generally poor with 50% of patients dying within 5 years.
Portal hypertension
Portal hypertension can be caused by conditions that block the portal vein (precirrhotic) or damage the liver (cirrhotic). It leads to complications like ascites, esophageal varices, and bleeding. Symptoms include abdominal swelling and pain, bleeding, and fatigue. Treatment focuses on reducing portal pressure through dietary changes, diuretics, banding or sclerotherapy of varices, transjugular intrahepatic portosystemic shunting (TIPS), or surgery in severe cases.
8.cor pulmonale
Cor pulmonale is enlargement, dilatation, hypertrophy or failure of the right ventricle in response to increased load from pulmonary hypertension caused by lung or pulmonary vessel disorders. It can be acute or chronic. Chronic cor pulmonale causes thickening of the right ventricular walls, while acute cor pulmonale causes dilation and wall thinning. Causes include chronic obstructive pulmonary disease, diffuse pulmonary fibrosis, pulmonary thromboembolism, primary pulmonary hypertension, and extensive pulmonary arteritis.
Hepatopulmonary syndrome by Albin Joseph
Hepatopulmonary syndrome (HPS) is characterized by liver disease, intrapulmonary vascular dilatations, and impaired oxygenation. It has a prevalence of 4-47% in adults with liver disease. The pathophysiology involves dilated pulmonary capillaries leading to ventilation-perfusion mismatching. Clinical features include cyanosis, clubbing, and low oxygen saturation. Diagnosis involves abnormal arterial blood gases and bubble echocardiography demonstrating intrapulmonary shunting. While liver transplantation effectively treats HPS, the case presentation describes a patient's complex postoperative course including nitric oxide supplementation and tracheostomy who ultimately was successfully decannulated.
Recent advance management of portal hypertension
This document discusses recent advances in the management of portal hypertension. It begins by defining portal hypertension and explaining how hepatic venous pressure gradient (HVPG) is used to measure it. HVPG thresholds of 10 mmHg and above indicate clinically significant portal hypertension. The document then discusses the pathophysiology of portal hypertension, focusing on the roles of hepatic stellate cells, angiogenesis, nitric oxide, and other vasoactive substances. It also summarizes evidence on the uses of beta-blockers, statins, and other drugs to reduce portal pressure. Several novel drug targets for managing portal hypertension are mentioned as areas of ongoing research.
Hepato pulmonary syndrome
Hepato-Pulmonary Syndrome (HPS) is characterized by liver disease, abnormal gas exchange, and vascular dilations in the lungs. It is caused by an imbalance of vasodilator and vasoconstrictor agents due to overproduction of vasodilators from injured liver tissue. This leads to widespread pulmonary vasodilatation and right-to-left shunting of blood, causing hypoxemia. HPS is diagnosed based on evidence of liver disease, hypoxemia that improves with 100% oxygen, and findings of intrapulmonary vasodilatations. Mild cases are monitored while severe cases receive long-term oxygen supplementation and possibly liver transplantation.
Portal hypertension by kiran maindale
Portal hypertension occurs when blood pressure in the portal vein system, which drains blood from the gastrointestinal tract to the liver, increases above normal levels. It is defined as a hepatic venous pressure gradient greater than 15 mmHg. Two key factors that contribute to portal hypertension are increased vascular resistance and increased blood flow. Investigation may include blood tests and imaging of the liver, portal system, and varices. Complications include variceal bleeding, ascites, and hepatic encephalopathy. Treatment depends on severity but may involve medication, endoscopic procedures, transjugular intrahepatic portosystemic shunt placement, or surgical shunting of blood flow to reduce portal pressure.
Pulmonary edema & cardiogenic apo
Acute pulmonary edema refers to excess fluid in the lungs that can have cardiogenic or non-cardiogenic causes. Cardiogenic pulmonary edema is often due to left ventricular dysfunction that leads to increased pulmonary capillary pressure. Common causes of left ventricular dysfunction include congestive heart failure, myocardial infarction, cardiomyopathy, and valvular diseases. Pulmonary edema progresses through three stages as excess fluid builds up first in small blood vessels then the lung interstitium and alveoli, impairing gas exchange.
thromboembolism
Thromboembolism refers to the blocking of blood vessels by particles that have broken away from clots in the body. It is common in patients with cardiac disease or impaired circulation. Intracardiac thrombi, which can be detected by echocardiogram, are especially common in patients with atrial fibrillation. Pulmonary embolism occurs when a thrombus breaks off and travels to the lung, often from a deep vein thrombosis. It can be treated with anticoagulants or thrombolytics. Pericardial effusion involves a buildup of fluid in the sac around the heart, which can lead to cardiac tamponade if pressure increases and compresses the heart.
Cor pulmonale
Cor pulmonale, or right heart failure caused by pulmonary or thoracic disease, can result from pulmonary arterial hypertension (PAH) due to conditions that obstruct the pulmonary vasculature. Common causes of PAH include heartworm disease, pulmonary thromboembolism from conditions causing blood stasis or hypercoagulability, and chronic lung diseases. Physical exam may reveal murmurs, respiratory distress, and signs of congestion. Diagnosis involves detecting abnormal gas exchange on bloodwork, radiographic evidence of lung disease or right heart enlargement, and ECG changes reflective of right heart strain. However, diagnosing the underlying cause like pulmonary thromboembolism can be challenging as exams and tests may be normal in some
Pulmonary edema
Pulmonary edema is the accumulation of fluid in the lungs, which makes breathing difficult. It occurs when fluid leaks into the tiny air sacs in the lungs called alveoli. This fluid buildup is usually due to heart failure or conditions that increase blood pressure in the lungs. Common symptoms include shortness of breath, cough, and wheezing. Diagnosis involves listening to the chest, chest x-rays, and echocardiograms. Treatment focuses on reducing fluid buildup through diuretics, oxygen therapy, and treating the underlying cause.
7 cor pulmonale
Cor Pulmonale, also known as pulmonary heart disease, is caused by high blood pressure in the lungs secondary to diseases affecting the lungs, chest wall, or pulmonary vasculature. It is characterized by hypertrophy and dilation of the right ventricle of the heart in response to the elevated pulmonary pressures. The main symptoms include cough, sputum production, shortness of breath, fatigue, and leg swelling. Diagnosis involves assessing the patient's medical history along with tests such as chest x-rays, electrocardiograms, echocardiograms, and blood gas analysis. Treatment focuses on controlling infections, improving oxygen levels, managing heart failure, and preventing complications through patient monitoring and education.
Portal Hypertension
The portal vein is formed by the superior mesenteric and splenic veins. It drains blood from the intestines, pancreas, colon and rectum. Blood from the portal and hepatic arteries mixes in the liver sinusoids before draining into the hepatic vein and inferior vena cava. Portal hypertension occurs when pressure increases due to increased resistance in the liver from cirrhosis and increased blood flow. It can cause ascites, variceal bleeding, and other complications.
Pulmonary hypertension
The pulmonary vascular circuit has low resistance and carries 70ml of blood normally. Blood flow is normally higher in the lung bases than apices due to gravity. The pulmonary arteries have a small diameter of 3mm or less in the upper intercostal spaces. Pulmonary hypertension is defined as a sustained elevation of pulmonary arterial pressure over 25mmHg at rest or 30mmHg during exercise, with normal pulmonary capillary wedge pressure and left ventricular end-diastolic pressure. Signs on chest X-ray include enlarged pulmonary arteries, loss of peripheral vessel markings, and enlargement of the right side of the heart in advanced disease.
Pulmonary Edema - Case Presentation
This document presents the case of a 74-year-old male who presented to the emergency department with acute exacerbation of breathlessness, cough with expectoration, and chest pain. On examination, he had tachypnea, hypoxemia, coarse crepitations on lung auscultation, tachycardia, and elevated blood pressure. Investigations revealed anemia and echocardiography showed left ventricular hypertrophy, systolic dysfunction, and diastolic dysfunction. He was diagnosed with acute left heart failure with pulmonary edema and treated with oxygen, diuretics, antibiotics, vasodilators, and transferred to the ICU.
Pulmonary edema roge ppt (1)
Pulmonary edema is the accumulation of fluid in the interstitium and alveoli of the lungs. It can be caused by conditions that increase hydrostatic pressure or decrease oncotic pressure leading to fluid movement from capillaries into lung tissue. The main types are cardiogenic pulmonary edema from heart failure or damage and non-cardiogenic edema from toxic inhalation or infections. Symptoms range from shortness of breath to cough with frothy sputum. Diagnosis involves physical exam, chest x-ray, and tests like ABG analysis and echocardiogram. Treatment focuses on oxygen therapy, positioning, diuretics, and vasodilators to reduce pulmonary congestion.
Pulmonary HTN
Pulmonary hypertension (PH) is defined as a mean pulmonary artery pressure ≥25 mmHg at rest. It is characterized by elevated pulmonary pressures and secondary right ventricular failure. PH can be caused by genetic mutations, pulmonary arterial hypertension (PAH) second hits like congenital heart disease or HIV, or pulmonary venous hypertension second hits like COPD or heart failure. Symptoms include dyspnea, chest pain, syncope, and edema. Diagnostic testing includes echocardiogram, right heart catheterization, and blood tests. Treatment involves diuretics, oxygen, anticoagulation, and advanced therapies for PAH like vasodilators or lung transplantation.
Fwd: Bambury lecture on venous and lymphatic disorders of the limb
---------- Forwarded message ----------
From: Henning L. Stokmo <helangen@gmail.com>
Date: 2009/2/12
Subject: Bambury lecture on venous and lymphatic disorders of the limb
To: ucdgrad09@gmail.com
Upper GI bleeding & portal hypertension in Children
This document discusses signs and symptoms of gastrointestinal bleeding, including melena, haematemesis, and haematochezia. It covers evaluation, treatment, and management of variceal bleeding including pharmacologic therapies, endoscopic procedures like band ligation and sclerotherapy, and surgical options like shunts and transplantation.
Pulmonary edema
Pulmonary edema is a condition caused by excessive fluid in the lungs, making it difficult to breathe. There are two main types: cardiogenic, caused by issues with the heart like weakened pumping from heart disease or damage, and non-cardiogenic, caused by things like drug use, smoke inhalation, or viral infections which damage the lungs. Complications can include swelling in the legs and abdomen. Treatment focuses on removing excess fluid with diuretics, relieving symptoms, and addressing the underlying cause.
What's hot (20)
Fwd: Bambury lecture on venous and lymphatic disorders of the limb
Fwd: Bambury lecture on venous and lymphatic disorders of the limb
Upper GI bleeding & portal hypertension in Children
Upper GI bleeding & portal hypertension in Children
Similar to Portal hypertention
Portal hypertension
Portal hypertension occurs when there is increased blood pressure in the portal vein system due to an obstruction of blood flow. This causes blood to flow through alternative veins and can lead to the development of varices and risk of bleeding. Portal hypertension has prehepatic, intrahepatic, and posthepatic etiologies and can be acute or chronic. Clinical features include variceal bleeding, ascites, and signs of liver dysfunction. Diagnosis involves ultrasound, CT, and endoscopy. Treatment includes nonselective beta blockers, transjugular intrahepatic portosystemic shunts, and surgery to shunt blood flow. Complications are bleeding varices, hepatorenal syndrome, and infections.
PORTAL HYPERTENSION.pptx
This document discusses portal hypertension, beginning with definitions and anatomy. It then covers the causes of portal hypertension including presinusoidal, sinusoidal, and postsinusoidal etiologies. The main clinical manifestations are gastrointestinal bleeding, splenomegaly, and encephalopathy. Diagnosis involves blood tests, imaging, and endoscopy. Treatment of acute bleeding involves fluid resuscitation, antibiotics, vasoactive drugs, endoscopic therapies, and shunt procedures if bleeding persists.
portal hypertension.pdf
Portal hypertension refers to increased pressure in the portal venous system, which normally ranges from 7 to 10 mmHg. It is defined as a pressure over 12 mmHg. The portal system involves the superior mesenteric and splenic veins joining to form the portal vein behind the pancreas. Portal hypertension can be prehepatic (obstruction before the liver), intrahepatic (obstruction in the liver), or posthepatic (obstruction after the liver). Clinical features include vomiting blood, bleeding from the rectum, ascites, and altered mental status. Investigations include blood tests, endoscopy, ultrasound, and imaging scans. Treatment involves supportive care, medications like beta blockers, and surgical procedures.
Portal venous doppler
Portal hypertension represents increased pressure within the portal vein and its tributaries. It is defined as an increase in pressure gradient between the portal vein and hepatic veins or IVC. Normal portal venous pressure is 5-10 mm Hg. Portal hypertension can be obstructive, prehepatic, hepatic, hyperkinetic, or posthepatic in nature. USG signs of portal hypertension include a portal vein diameter greater than 13mm, portal vein pressure greater than 10mmHg, and portal vein velocity less than 16mmHg.
PORTAL HYPERTENSION Adult HealthNursing .pptx
Portal hypertension occurs when there is high blood pressure in the portal vein system, which can be caused by liver cirrhosis or other conditions that impede blood flow through the liver. It is defined as a portal pressure over 12 mmHg. Common causes include liver damage from alcohol abuse, hepatitis, or schistosomiasis. Symptoms include gastrointestinal bleeding, ascites, and confusion. Portal hypertension is classified as prehepatic, intrahepatic, or posthepatic depending on whether the cause is before, within, or after the liver. Treatment involves procedures to relieve pressure such as TIPS or surgery.
Oesophageal varice
Esophageal varices develop as portosystemic collaterals when portal pressure exceeds 12 mmHg, usually due to cirrhosis or other causes of portal hypertension. Clinical features include upper gastrointestinal bleeding. Management involves prevention of initial bleeding and rebleeding through drug treatment (octreotide, vasopressin), endoscopic therapy (band ligation, sclerotherapy), TIPSS procedures, or surgery (shunts, splenectomy, transplantation). The goal is to reduce portal pressure and control acute bleeding episodes.
Portal Hypertension.pptx
This document defines and describes portal hypertension. It begins by defining portal hypertension as an increased pressure within the portal venous system, characterized by increased pressure throughout the portal circulation. The most common cause is cirrhosis of the liver. It then discusses the etiology, pre-hepatic, intra-hepatic, and post-hepatic causes. Clinical manifestations include ascites, abdominal pain, splenomegaly, thrombocytopenia, and anorectal varices. Diagnostic studies and treatments such as portosystemic shunts and TIPS are also outlined.
Portal hypertension in paediatrics
The document discusses portal hypertension in children. It covers the anatomy of the portal system, causes/classifications of portal hypertension, clinical manifestations, diagnosis, and treatment. Regarding diagnosis, it describes using endoscopy to identify varices, ultrasound to detect portal vein thrombosis, and CT/MRI/venography to further evaluate vascular anatomy. Treatment of acute variceal bleeding involves stabilizing the patient and reducing portal pressure to stop bleeding.
Portal htn by magdi sasi 2015
This document discusses portal hypertension and esophageal varices. It begins by defining portal hypertension as increased blood pressure within the portal venous system, usually caused by cirrhosis of the liver obstructing blood flow. Esophageal varices develop as collateral blood vessels when portal pressure exceeds 12 mmHg. The document then covers causes of portal hypertension, risk factors for bleeding varices, clinical presentation, investigations including endoscopy, and treatment approaches focusing on preventing or managing bleeding from varices.
Portal hypertension
Portal hypertension occurs when blood pressure increases in the portal venous system, which normally carries blood from the gastrointestinal tract to the liver. It is defined as a hepatic venous pressure gradient over 10mm Hg. There are three types - pre-hepatic, intra-hepatic, and post-hepatic - depending on the site of vascular obstruction. Common causes include cirrhosis, schistosomiasis, and portal vein thrombosis. Clinical manifestations involve complications from increased portosystemic shunting and include ascites, esophageal varices, hemorrhoids, and hepatic encephalopathy. Diagnostic evaluations involve blood tests, imaging, and endoscopy. Treatment options include medications, endoscopic therapy, TIPS procedure,
GENERAL PHYSICAL EXAMINATION OF GIT, RS,.pptx
This document provides details on performing a general physical examination of the gastrointestinal system, respiratory system, cardiovascular system, and central nervous system. Some key findings include:
- Increased weight can indicate non-alcoholic steatohepatitis (NASH) while decreased weight can indicate malignancy.
- Clubbing of the fingers can indicate primary biliary cirrhosis, inflammatory bowel disease, or hepatocellular carcinoma.
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portal hypertension..classification and pathophysiology.
The document discusses portal hypertension by defining it, describing the anatomy of the portal system, and explaining the pathophysiology. It notes that portal hypertension results from increased resistance to blood flow through the liver from the portal vein. This can be caused by structural changes in the liver from conditions like cirrhosis, which decrease portal vein radius and dramatically increase resistance. The pathophysiology involves three components: increased intrahepatic resistance from factors like activated hepatic stellate cells and endothelial dysfunction; remodeling of sinusoids and angiogenesis; and the development of collateral blood vessels.
Cirrhosisofliver
Cirrhosis is a diffuse process characterized by liver necrosis and fibrosis that converts the normal liver architecture into abnormal nodules lacking normal structure. It has many causes including viral hepatitis, alcohol, autoimmune conditions, and genetic disorders. Complications of cirrhosis arise from portal hypertension and liver insufficiency, leading to variceal bleeding, ascites, encephalopathy, and jaundice. Cirrhosis is diagnosed based on clinical signs, lab tests, imaging, and may involve liver biopsy. Management focuses on treating complications and screening for hepatocellular carcinoma.
CLD Diagnosis and management………………..pptx
This document discusses the definition, causes, clinical presentation, and management of complications of chronic liver disease (CLD). It defines CLD as progressive liver destruction over 6 months leading to fibrosis and cirrhosis. Common complications include esophageal variceal bleeding, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, and hepatorenal syndrome. Causes include alcohol, viral hepatitis, NAFLD/NASH, and genetic/autoimmune conditions. Clinical features depend on whether the cirrhosis is compensated or decompensated. Management involves treating the specific complications, such as band ligation for esophageal varices, diuretics and albumin for ascites, and antibiotics for spontaneous bacterial periton
Portal hypertension in children
Portal hypertension in children is caused by a blockage in the portal vein that increases blood pressure. The most common cause is prehepatic blockages from blood clots or narrowing of the portal vein before it reaches the liver. This forces the growth of bypass veins that increase pressure. Cirrhosis is the second most common cause. Clinical presentations include gastrointestinal bleeding from esophageal varices, spleen enlargement with low blood cell counts, brain changes from ammonia, and fluid in the abdomen. Diagnosis involves imaging of the liver and veins. Complications are bleeding, fluid buildup, and brain changes. Treatment focuses on reducing blood pressure through medications, procedures to treat varices, and shunts.
Portal hypertension
This document provides information on portal hypertension, including its definition, causes, presentations, investigations, and management. Some key points:
- Portal hypertension is defined as a sustained elevation of portal pressure above 12 mm Hg. It can be caused by conditions affecting blood flow pre-sinusoidally (e.g. portal vein thrombosis), sinusoidally (e.g. cirrhosis), or post-sinusoidally (e.g. Budd-Chiari syndrome).
- Common presentations include esophageal varices, splenomegaly, ascites, and features of hepatic encephalopathy. Investigations include liver function tests, ultrasound, and endoscopy to identify varices.
-
Portal hypertension
Portal hypertension occurs when there is increased resistance to blood flow through the portal vein, causing elevated pressure. It is defined as a hepatic venous pressure gradient over 5 mmHg. Measurement involves catheterization of the hepatic vein. Causes include cirrhosis and other liver diseases. Complications include variceal bleeding, ascites, and encephalopathy. Treatment of acute bleeding involves vasoactive drugs, endoscopic therapy, and TIPS. Secondary prevention uses beta-blockers to reduce portal pressure and risk of rebleeding.
portal hypertension and upper G I bleeding
This document discusses portal hypertension (PHT), including its definition, classification, etiology, pathophysiology, clinical features, diagnosis and management. PHT is defined as a pathological increase in portal pressure above 5 mmHg. It can be classified based on the location of obstruction as pre-sinusoidal, sinusoidal, or post-sinusoidal. The etiology includes pre-hepatic causes such as portal vein thrombosis, intra-hepatic causes like cirrhosis, and post-hepatic causes like Budd-Chiari syndrome. Clinical features include upper GI bleeding, splenomegaly, ascites, and varices. Diagnosis involves clinical evaluation, endoscopy, imaging like ultrasound, and treatment depends
Portal hypertension
Portal hypertension is elevation of portal venous pressure
above 10-12 mm Hg (normal 5-10 mm Hg). Portal
hypertension results from (a) increased resistance to portal
blood flow and (b) high portal blood flow.
Similar to Portal hypertention (20)
portal hypertension..classification and pathophysiology.
portal hypertension..classification and pathophysiology.
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Thyroid carcinoma
Thyroid carcinoma is the most common endocrine malignancy, affecting women three times more than men. Risk factors include exposure to radiation, family history, low iodine diet, and older age. Symptoms can include a lump in the neck, hoarseness, difficulty swallowing or breathing. Treatment options include surgery to remove all or parts of the thyroid gland, hormone therapy, radioactive iodine therapy, external beam radiation, chemotherapy, or targeted therapy depending on the cancer stage.
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Pneumonia
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.
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Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
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Streptococcus pyogenes
Streptococcus pyogenes
Streptococcus pyogenes.jpg
S. pyogenes bacteria at 900x magnification
Scientific classification
Kingdom: Eubacteria
Phylum: Firmicutes
Class: Bacilli
Order: Lactobacillales
Family: Streptococcaceae
Genus: Streptococcus
Species: S. pyogenes
Binomial name
Streptococcus pyogenes
Rosenbach 1884
Streptococcus pyogenes is a species of Gram-positive bacteria. These bacteria are aerotolerant and an extracellular bacterium, made up of non-motile and non-sporing cocci. As expected with a streptococci, it is clinically important in human illness. It is an infrequent, but usually pathogenic, part of the skin microbiota. It is the predominant species harboring the Lancefield group A antigen, and is often called group A streptococcus (GAS). However, both Streptococcus dysgalactiae and the Streptococcus anginosus group can possess group A antigen. Group A streptococci when grown on blood agar typically produces small zones of beta-hemolysis, a complete destruction of red blood cells. (A zone size of 2–3 mm is typical.) It is thus also called group A (beta-hemolytic) streptococcus (GABHS), and can make colonies greater than 5 mm in size.[1]
Like other cocci, streptococci are round bacteria. The name is derived from Greek words meaning chain(Strepto) of berries (coccus) and pus(pyo)-forming(genes), because streptococcal cells tend to link in chains of round cells (see image) and a number of infections caused by the bacterium, produce pus. Streptococci are can be catalase positive or negative.[2] S. pyogenes can be cultured on blood agar plates. Under ideal conditions, it has an incubation period of 1 to 3 days.[3]
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Portal hypertention
- 2. • NORMAL RANGE OF PORTAL VENOUS PRESSURE (5-10)mm of hg. • PORTAL HYPERTENTION IS DEFINED AS THE ELEVATION OF THIS PRESSURE GRADIENT TO VALUES ABOVE (10-12)mm of hg. • PHT: Is the pathological increase in the portal pressure in which the pressure gradient b/w the portal vein and IVC is increased above the upper limit of 10mm of hg. • PPG>10mm hg -VARICES • PPG>12mmhg –VARICEAL BLEEDING,ASCITES
- 5. ETIOLOGY • PRE HEPATIC • INTRA HEPATIC • POST HEPATIC
- 6. • PRE HEPATIC-Caused by obstruction of blood flow at level of portal vein. • Ex: conginetal atresia , extrinsic compression , thrombosis( portal, superior mesenteric , splenic vein ) , cirrhosis . • INTRA HEPATIC • POST HEPATIC-caused by obstruction of blood flow at the level of hepatic vein. • Ex: budd chiari syndrome ,chronic heart failure ,constrictive pericarditis.
- 11. DIAGNOSIS • CLINICAL • UPPER GI ENDOSCOPY • US/DOPPLER
- 12. CLINICAL FEATURES • GROWTH RETARDATION • PORTO PULMONARY HYPERTENTION • HEPATO RENAL SYNDROME • HEPATO PULMONARY SYNDROME
- 13. COMPLICATIONS • UPPER GI BLEEDING(VARICEL) • ASCITES • HEPATIC ENCEPHALOPATHY
- 14. TREATMENT • PHARMACOLOGICAL: BETA BLOCKERS ,NITRATES(PREVENTION) • TX: VASOPRESSIN, SOMATOSTATIN , OCTREOTIDE • ENDOSCOPY: ENDOSCOPIC SCLEROTHERAPY , ENDOSCOPIC VARICEAL LIGATION • BALLOON TAMPONADE • TIPS: TRANS JUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT • SURGICAL: LIVER TRANSPLANT , SHUNTS, DEVASCULARIZATION
- 15. THANK YOU