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pulmonary hypertension

Description

Paediatrics (Cardio) Mind Map on pulmonary hypertension, created by v.djabatey on 01/29/2014.
v.djabatey
Mind Map by v.djabatey, updated more than 1 year ago
v.djabatey
Created by v.djabatey over 8 years ago
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Resource summary

pulmonary hypertension
  1. causes
    1. pulmonary arterial hypertension
      1. idiopathic
        1. sporadic
          1. familial
          2. post-tricuspid shunts
            1. VSD
              1. AVSD
                1. PDA
                2. HIV infection
                  1. persistent pulmonary hypertension of newborn
                  2. pulmonary venous hypertension
                    1. left-sided heart disease
                      1. pulmonary vein stenosis or compression
                      2. pulmonary hypertension w/ respiratory disease
                        1. obstructive sleep apnoea or upper airway obstruction
                          1. chronic obstructive or premature lung disease
                            1. interstitial lung disease
                            2. pulmonary thromboembolic disease
                              1. pulmonary inflammatory or capillary disease
                              2. =high pulmonary Pa, mean > 25mmHg
                                1. most kids w/ pul HTN have a large post-tricuspid shunt w/ high pul blood flow & low resistance
                                  1. e.g. VSD, AVSD, PDA
                                  2. Pa falls to normal if defect surgically corrected within 6 months old
                                    1. if left untreated
                                      1. high flow and Pa causes irreversible damage to pulmonary vascu bed (pul vasc disease)
                                        1. not correctable except by heart/lung transplant
                                    2. Rx
                                      1. act on pulmonary vasc on cGMP pathway
                                        1. inhaled nitric oxide
                                          1. iv magnesium sulphate
                                            1. oral phosphodiesterase inhibitors
                                              1. e.g. sildenafil
                                            2. act on cAMP pathway
                                              1. iv prostacyclin
                                                1. inhaled iloprost
                                                2. endothelin receptor antagonists
                                                  1. oral Bosentan
                                                  2. anticoagulation
                                                    1. heparin
                                                      1. aspirin
                                                        1. warfarin
                                                        2. to delay transportation
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