Day 223 - Pulmonary Hypertension

Cindy was diagnosed with Pulmonary Hypertension.  Pulmonary Hypertension occurs when there is an increase in pressure in the pulmonary arteries - the arteries that carry blood form the heart to the lungs.  The diagnosis is based on the readings from the Pulmonary Artery Catheter (see post Day 221 - Pulmonary Artery Catheterization).

Picture of Heart from Wikipedia

This is how the heart works:

1. The right atrium (upper right side of the heart) pumps de-oxygenated blood to the right ventricle.
2. The right ventricle (lower right side of the heart) pumps blood to the the pulmonary arteries.  
3. The blood flows to the lungs
4. The blood picks up oxygen
5. The blood flows to the left atrium (upper left side of the heart) 
6. The blood is pumped to the left ventricle (lower left side of the heart) 
7. The blood is pumped to the rest of the body.through the aorta

Cindy's pulmonary arteries have become inflamed.  The inflamation is due to one or more of the following:

1. A blood clot
2. Plaque in the arteries
3. The arteries are damaged for other reasons

What does this mean?

1. Her heart cannot push blood through her pulmonary arteries and into her lungs
2. Pressure increases in the arteries
3. Her heart has to work harder to pump the blood
4. Her right ventricle has become weak
5. Fluid backs up causing fluid retention
6. Her lungs aren't  getting enough blood
7. Her left ventricle doesn't have enough blood to push through the rest of her body (Heart failure)
8. Her kidneys start to fail because they are not getting enough blood.  Her kidneys work enough to flush waste but not enough for her to produce urine.

What is the plan?

1. Administer medication to the heart to get her out of heart failure.  This includes medication to strengthen the right side and calm down the left side.
2. Increase fluid intake, reduce saline, administer diuretics to get her out of kidney failure and remove excess fluids.
3. When kidneys start to work better, check for a clot in her lung.  Due to her kidney problem, the procedure could not be done.  She is currently getting a blood thinner in the assumption she has a blood clot.  The blood thinner cannot be used with some of the medications that would help her heart. 

This is a lot of information to understand and can be confusing.   If you have any questions, you can leave it for me in the comments section.

QUIZ:

Fill in the blank:

Viagra was initially developed as a medication for _______________________.

Answer in tomorrow's post.