1. Pulmonary Hypertension Sung Chul Hwang, M.D. Dept of Pulmonary and Critical Care Medicine Ajou University School of Medicine

2. Pulmonary Hypertension A Disease state in which there is a persistent increase in Pulmonary Artery Pressure of more than 5 - 10 mmHg above the normal value

3. Measurements (I) P PA = P LA + (Qp X PVR) or PVR= P PA - P LA /Qp P PA : Mean Pulmonary Artery Pressure P LA : Mean Left Atrial Pressure Qp : Pulmonary Blood Flow PVR : Pulmonary Vascular Resistance

4. Fick’s Principle Qp= VO2 1 CaO2-CvO2 X 10 L/min VO2 : Oxygen Uptake CaO2 : Oxygen content of Aterial Blood CvO2 : Oxygen content of Venous Blood

5. Normal Values Pulmonary artery pressure : 25/10mmHg Exercise  initial rise with plateau at 7 min Qp : 4 L/min/m 2

6. Causes of Pulmonary Hypertension Obstructive Primary pul. hypertension Thrombo- embolism Tumor emboli Hypoxic Cor Pulmonale Restrictive lung diseases High altitude Alveolar hypoventilation

7. Pathology normal Cor Pulmonale

8. Biventricular Hypertrophy LV RV

9. Hypertrophic Pulmonary Osteoarthropathy (Clubbing)

10. RV Failure (DCMP)

11. Tricuspid Regurgitation

12. P-Pulmonale

13. Pulmonary Arterial Hypertrophy

15. PA Hypertrophy

17. RV Hypertrophy

19. P-pulmonale

20. Pulmonary Hypertension