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Pulmonary Hypertension: “You Take My Breath Away”

  • Jennifer CottonEmail author
  • Eric Adkins
Chapter

Abstract

Pulmonary hypertension is a disease process affecting the pulmonary vasculature and right heart with a high morbidity and mortality. Increases in pulmonary vasculature pressures cause both diastolic and systolic dysfunction of the right ventricle. The resulting preload-dependent output of the right ventricle makes patients sensitive to small fluid losses. The dilation of the right ventricle also causes increases in fluid volume to overstretch the right ventricle and reduce contractility. As a result, pulmonary hypertension patients live within a narrow margin of fluid balance. To aid right heart function many patients are continuously infused medication to reduce pulmonary resistance and right ventricle afterload. However, this also comes with complications, especially when there is an abrupt failure in the delivery of these medications. Overall, these are difficult patients to manage during acute episodes of decompensation due to their marginal cardiac function, hypersensitivity to changes in volume status, and limited usefulness of many exam findings or tests used to assess volume status.

Keywords

Pulmonary hypertension Right heart failure Respiratory distress Cardiac emergencies Pulmonary emergencies Critical care Emergency medicine Ultrasound 

Notes

Disclosure Statement

The authors of this chapter report no significant disclosures.

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Emergency Medicine, Department of SurgeryUniversity of Utah HospitalSalt Lake CityUSA
  2. 2.Department of Emergency MedicineWexner Medical Center at The Ohio State UniversityColumbusUSA

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