Pulmonary Arterial Hypertension: Difference between revisions
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* PH or PHTN is a condition of increased blood pressure in the arteries of the lungs. | * PH or PHTN is a condition of increased blood pressure in the arteries of the lungs. | ||
* It has two types | |||
*# Primary PH (resulting from a disease of the pulmonary arteries) | |||
*# Secondary PH (resulting secondary to other, non-vascular causes). | |||
=== | === Signs / Symptoms === | ||
* Shortness of breath / Cyanosis | |||
* [[Fatigue]] | |||
* Chest pain | |||
* Palpitations | |||
* Right-sided abdominal pain | |||
* Poor appetite | |||
* Lightheadedness / [[Syncope|Fainting]] | |||
* Swelling (Legs/ Ankles) | |||
=== Pathogenesis === | === Pathogenesis === | ||
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* These result in a severe vasoconstriction and vascular smooth muscle and adventitial hypertrophy characteristic of patients with PAH. | * These result in a severe vasoconstriction and vascular smooth muscle and adventitial hypertrophy characteristic of patients with PAH. | ||
=== | |||
=== [[Miasms]] === | |||
[[HHV-8, Human Herpes Virus 8|HHV-8]] | [[HHV-8, Human Herpes Virus 8|HHV-8]] |
Revision as of 06:47, 24 June 2023
Clinic
- PH or PHTN is a condition of increased blood pressure in the arteries of the lungs.
- It has two types
- Primary PH (resulting from a disease of the pulmonary arteries)
- Secondary PH (resulting secondary to other, non-vascular causes).
Signs / Symptoms
- Shortness of breath / Cyanosis
- Fatigue
- Chest pain
- Palpitations
- Right-sided abdominal pain
- Poor appetite
- Lightheadedness / Fainting
- Swelling (Legs/ Ankles)
Pathogenesis
- The pathogenesis of pulmonary arterial hypertension (WHO Group I) involves the narrowing of blood vessels connected to and within the lungs.
- This makes it harder for the heart to pump blood through the lungs, as it is much harder to make water flow through a narrow pipe as opposed to a wide one.
- Over time, the affected blood vessels become stiffer and thicker, in a process known as fibrosis.
- The mechanisms involved in this narrowing process include vasoconstriction, thrombosis, and vascular remodeling (excessive cellular proliferation, fibrosis, and reduced apoptosis/programmed cell death in the vessel walls, caused by inflammation, disordered metabolism and dysregulation of certain growth factors).
- This further increases the blood pressure within the lungs and impairs their blood flow.
Molecular pathology
- The molecular mechanism is not known yet, but it is believed that the endothelial dysfunction results in a decrease in the synthesis of endothelium-derived vasodilators such as nitric oxide and prostacyclin.
- Moreover, there is a stimulation of the synthesis of vasoconstrictors such as thromboxane and vascular endothelial growth factor (VEGF).
- These result in a severe vasoconstriction and vascular smooth muscle and adventitial hypertrophy characteristic of patients with PAH.