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45 Cards in this Set

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systemic hypertension
Defined 140/90 mmhg
systolic > 140
diastolic >90
On three consequative measurements
BP represents the force of blood against any unit area of the vessel wall
systemic hypertension
Primary HTN:etiology unknown (90-95%)
Secondary HTN: the cause can be identifies,renal, endocrine,neurological dx's, drugs, food
systemic hypertension
white coat
You are nervouse Increased BP while in Dr's office and normal elsewhere
Borderline HTN
BP 150/90 to 160/100
Mild HTN
diastolic 90-105
systemic hypertension
Defined 140/90 mmhg
systolic > 140
diastolic >90
On three consequative measurements
BP represents the force of blood against any unit area of the vessel wall
systemic hypertension
Primary HTN:etiology unknown (90-95%)
Secondary HTN: the cause can be identifies,renal, endocrine,neurological dx's, drugs, food
systemic hypertension
white coat
You are nervouse Increased BP while in Dr's office and normal elsewhere
Borderline HTN
BP 150/90 to 160/100
Mild HTN
diastolic 90-105
systemic hypertension
mild
diastolic BP 90-105 mmHg
systemic hypertension
moderate
diastolic BP 105-114 mmHg
systemic hypertension
severe
diastloic BP 115-129 mmHg
systemic hypertension
Malignant-acclerated
diastolic BP > 120 mmHg
systemic hypertension
systolic HTN
systolic BP > 150 mmHg
systemic hypertension
Resistant
Does not respond to tx
systemic hypertension symptoms that you may be able to control
smoking alcohol diet salt intake obesity lifestyle work family situation oral contraceptives decongestants
systemic hypertension
physical signs
Asymptomatic
headaches dyspnea palpitations headaches blurred vision dizziness sweats
systemic hypertension
symptom you can't control
Family history of HTN, diabetes, ischemic heart dz
Race and age african american sedentary individuals
systemic hypertension
2d findings
Determine LV dim. & concentric LV hypertrophy
Eval LV end diastolic midcavity obliteration (hypovolemia and Increased contractility)
Det LVOT gradient w/ CW
Speckled ground glass appearance-as. w/ severe HTN or chronic renal failure RVH
Eval aorta-(coarc, dilated, aneurysmal, dissected) serial echos to determine effect of therapy
systemic hypertension
Complications
atherosclerotic-angina myo ischemia acute MI-most common cause of death in HTN pts
CHF TIA/Stroke hypertensive renal dz &retinopathy aortic dissection
systemic hypertension
Treatment
Non pharmacological-weight loss-lifestyle
Pharm-Diuretics (1st choice)Beta blockers
Treat secondary cause
systemic hypertension results
Increase in vascular resistance and LV afterload leading to LVH, diastolic dysfx, and eventuall end systolic dysfx
systemic hypertension
Body systems most affected
Brain, heart, kidneys, blood vessels
systemic hypertension
Diabetic risk
Increases the risk of stroke, renal failure and CAD
systemic hypertension
African American Male
40% of AA males over the age of 50 have systemic HTN
systemic hypertension
Bottom line
The higher the BP the greater the cardiovascular risk
Pulmonary Hypertension
Definition
An INCREASE in PAP pulmonary artery pressure due to REDUCTION in the caliber of the pulmonary vasculature OR an INCREASE in pulmonary blood flow---Or both
Pulmonary Hypertension
What are primary types of PTHN
Three:
unknown etiology
raynaud's syndrome
Oral Contraceptive's
Pulmonary Hypertension: What are some examples of seconday PHTN
Aquired heart dz, LV sys failure, LV diastolic failure, icshemic heart dx, MV, AV dx, myxomas etc heartlung dz's
Pulmonary Hypertension
Signs and symptoms
DOE, fatigue, dizzyness, syncope,CP, palpations, orthopnea, cough, hoarseness, hemoptysis, cyanosis, R heart failure
Pulmonary Hypertension
2D Findings/Evaluation
Evidence of nderlying etiology (ischemic heart dz, MS) RVH (occurs early in PTHN)
D-shaped LV due to leftward shift of IVS
Dilation of IVC with failure to collapse with inspiration
RAE PA dilation PFO
Pulmonary Hypertension
Why might you have a shunt with PHTN?
The pressure has opened the patent foramen ovale back open
Pulmonary Hypertension
Treatment:
Treat the underlying cause first!
Pulmonary Hypertension
Treatment: Meds:
Pulmonary vasodilators
Anti-inflammatory agents
Diuretics, Digitalis/Dopamine
Pulmonary Hypertension:
Treatment: Think lifestyle change/ What causes increase swelling
REDUCE salt in diet
Pulmonary Hypertension
Treatment: What would you condsider if you had PHTN and had recurrent pulmonary emboli
Inferior vena cava filter
Pulmonary Hypertension
Treatment: Most extreme measure
Heart-Lung transplant
Pulmonary Hypertension:What is the measurement criteria for PTHN: What is and increase in PAP
>30mmHg SYSTOLIC Which may result in the pressure overload of the right heart
Pulmonary Hypertension
what is the order of how PTN affects the heart (mechanics)
THe RV first responds with RVH, RVE, TR, PR, and RAE
Pulmonary Hypertension
Why might you have a shunt with PHTN?
The pressure has opened the patent foramen ovale back open
Pulmonary Hypertension
Treatment:
Treat the underlying cause first!
Pulmonary Hypertension
Treatment: Meds:
Pulmonary vasodilators
Anti-inflammatory agents
Diuretics, Digitalis/Dopamine
Pulmonary Hypertension:
Treatment: Think lifestyle change/ What causes increase swelling
REDUCE salt in diet
Pulmonary Hypertension
Treatment: What would you condsider if you had PHTN and had recurrent pulmonary emboli
Inferior vena cava filter