Pulmonary Vascular Disease

Presentation on Pulmonary Vasculature Student’s Name Institution Affiliation Course Date Introduction: Pulmonary Vasculature • Pulmonary Vasculature refers to the blood vessel network connecting the lungs and the heart. • The network transports oxygenated and deoxygenated blood. • This system well designed to work under changes in characteristics of the blood is transports. • Nonetheless, various infirmities may impair this system’s correct functioning. Anatomic Alterations of the Lungs • Anatomic alterations of the lungs may lead to infirmities related with the respiratory system. • Blood clots are among agents for anatomic alterations of the lungs. • Thrombus are blood clots that form in the veins. • When a thrombus detaches and flows to other body organs, it’s called an embolism. Pulmonary Embolism (PE) • Pulmonary embolism is a form of venous thromboembolic diseases. • It can be caused by a diverse number of inherited or acquired risk factors. • Causes can be: • A deep vein thrombosis (DVT). • Air bubbles. • Fat embolus • Tumors • Amniotic fluid • Small masses of infectious material. Cardiopulmonary Manifestations of PE • Cardiopulmonary manifestations associated with PE vary. • Majorly, common symptoms may include: • Sharp and sudden chest pain • Shortness of breath • Blood-streaked sputum in cough. • Fainting or feeling dizzy. • Leg pain and swelling. Diagnosis and Screening of PE • General management of PE involve the diagnosis and screening. • Diagnosis begins by identifying manifestations as shown earlier. • This is followed by a variety of tests and screening exercises. • Decisions are then made on the clinical probability through a scoring system. • These steps aid in the confirming the suspected occurrence of a PE. Pulmonary Hypertension (PH) • This condition impairs arteries in the lungs and the heart’s right side. • It is a form of high blood pressure whereby the pressure in the blood vessels to the lungs is extremely high. • Narrowed blood vessels in the lungs restrict blood from flowing well. • The heart is forced to work harder to pump blood, this can damage the heart and cause pulmonary hypertension. Clinical Classifications of Pulmonary Hypertension • There are five distinct classification of pulmonary hypertension. • They include: • Pulmonary arterial hypertension (PAH). • PH due to left-sided heart disease. • PH due to chronic lung disease • Chronic thromboembolic PH (CTEPH). • PH with an unclear and/or multifactorial mechanisms. Diagnosis for Pulmonary Hypertension • Diagnosis for pulmonary hypertension begins with a medical history and physical exam. • These seek to highlight the risk factors one may have. • After a physical exam, diagnostic tests are used to confirm diagnosis of PH. • Common diagnostic tests are cardiac catheterization and echocardiography. Pulmonary Hypertension Severity Rating • PH severity rating assessment is based on mean pulmonary artery pressure (mPAP). • This rating can be categorized as mild, moderate and severe depending on a mean value. • For instance, 25-40mmHg is a mild mPAP value while 41-55mmHg is a moderate value. Left-sided Heart Failure • There are two types of left-sided heart failure; systolic and diastolic failure. • Diastolic failure is concerned with the left ventricle not relaxing properly. • Systolic failure is concerned with the left ventricle not contracting normally. • Left-sided heart failure highly common compared to the right-sided one. • Symptoms include: • Trouble breathing • Shortness of breath Right-sided Heart Failure • This involves the heart’s right ventricle lack of pumping power. • This may lead to blood backing up into the veins. • Such backing up of blood may cause fluid retention and swelling. • Common sing include: • Chest discomfort and shortness of breath. • Fluid retention is one the hallmark symptoms. Respiratory Therapist • This is a healthcare practitioner trained in pulmonary medicine. • Their work is evaluating, monitoring and treating health issues associated with breathing and the lungs. • These therapists help manage breathing conditions in varying healthcare settings. Treatments for Acute Pulmonary Embolism • Acute PE can be treated using medicine, surgery or ongoing care. • Treatment is mainly aimed at preventing formation of new clots. • Treatment is also aimed at preventing small thrombi from getting bigger. • Medicine to treat PE include blood thinners and clot dissolvers. • Surgical procedures include clot removal and vein filter. Treatment for Acute Pulmonary Hypertension • Treating pulmonary hypertension will depend on the classification of PH. • Individuals with PAH are majorly treated using various targeted therapies starting with heart catheterization. • Patients with PH due to left heart disease require their comorbid conditions optimized. • Those with PH due to lung disease should focus on managing underlying lung disease. Treatment for Acute Pulmonary Hypertension • Curative therapy for patients with CTEPH begin with a pulmonary endarterectomy. • Whereas, little has been explored about many etiologies in multifactorial PH. • Other general therapy considerations exist. They include: • Immunization • Contraception • Mental health and patient education Conclusion • In conclusion, pulmonary vasculature refers to a network of blood vessels connecting the heart and lungs. • Pulmonary embolism, pulmonary infarction and pulmonary hypertension are among infirmities that may affect the pulmonary vasculature. • Various diagnostic test and screening can be used to diagnose pulmonary infirmities. • Once an infirmity is confirmed, treatment is recommended with respect to the particular disease identified. References American Thoracic Society. (2018). Pulmonary Embolism. https://www.thoracic.org/patients/patient-resources/resources/pulmonaryembolism.pdf Centers for Disease Control and Prevention. (2019). Pulmonary Hypertension. https://www.cdc.gov/heartdisease/pulmonary_hypertension.htm Dunlap, B. & Weyer, G. (2016). Pulmonary Hypertension: Diagnosis and Treatment. Am Fam Physician. 2016:94(6):463-469. https://www.aafp.org/pubs/afp/issues/2016/0915/p463.html#afp20160915p463-b14 References Fogoros, R. N. (2021). Causes and Risk Factors of Pulmonary Embolism. Verywell health. https://www.verywellhealth.com/causes-and-risk-factors-ofpulmonary-embolus-4163817#citation-2 Sysol, J. R. & Machado, R. F. (2018). Classificatio and Pathophysiology of Pulmonary Hypertension. Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1002/cce2.71 References Turetz, M., Sideris, A. T., Friedman, O. A., Triphathi, N., & Horowitz, J. M. (2018). Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism. Seminars in interventional radiology, 35(2), 92–98. https://doi.org/10.1055/s-0038-1642036 Yetman, D. (2021). What are the Differences Between Left- vs. Right-Sided heart Failure. Healthline. https://www.healthline.com/health/heartfailure/left-vs-right-sided-heart-failure