BLOCK 9: Pulmonary Hypertension
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Learning Objectives By Lesson
1-Definitions, Classification, & Testing
  • Describe the clinical importance for understanding pulmonary hypertension
  • Define pulmonary hypertension at rest
  • Describe how to differentiate between pre-capillary, post-capillary, and combined pulmonary hypertension
  • Define and identify potential etiologies for unclassified pulmonary hypertension
  • Describe how to idenitfy exercise-induced pulmonary hypertension
  • Describe the classificaiton pulmonary hypertension and their related causes
  • Describe the clinical characteristics associated with pulmonary hypertension
  • Identify warning signs of pulmonary hypertension that might suggest the need for hospitalization
  • Identify diagnostic testing in evaluation of pulmonary hypertension
  • Identify the gold standard diagnostic test and expected findings for diagnosising of pulmonary hypertension
  • Describe the role of and candidates for vasoreactivity testing during right heart catheterization in the evaluation of pulmonary hypertension
  • Define a positive vasoreactivity test during right heart catheterization
  • Identify genetic mutations assocaited with pulmonary arterial hypertension
2-Diagnosis & Risk Assessment
  • Review how to classify pulmonary hypertension
  • Describe the general diagnostic process for evaluating pulmonary hypertension
  • Describe the evaluation process when pulmonary hypertension is suspected
  • Describe the screening process for pulmonary hypertension
  • Identify at risk groups for pulmonary hypertension
  • Identify diagnostic tools used for screening for pulmonary hypertension
  • Describe the goals of clinical assessment for pulmonary hypertension
  • Describe the WHO funcational classification for pulmonary hypertension and its importance
  • Describe the imaging modalities and their associated findings of pulmonary hypertension
  • Identify parameters of prognostic values for patients with pulmonary hypertension
  • Describe the 3- and 4-strata models and their inputs for risk stratifying patients with pulmonary hypertension
  • Describe how to use the 3- and 4-strata models to achieve therapeutic goals for patients with pulmonary hypertension
3-Treatment: General Measures
  • Describe the general therapeutic measures in pulmonary hypertension management
  • List important counseling topics in pulmonary hypertension management
  • Describe the role of physical activity, anticoagulation, diuretics, and supplemental oxygen in the management of pulmonary hypertension
  • Describe different aspects of counseling in patients with pulmonary hypertension
  • Describe how to counsel women with pulmonary hypertension considering pregnancy or who are pregnant
  • Describe the role of contraception in women with pulmonary hypertension
  • Describe important considerations and risks for patients with pulmonary hypertension undergoing surgery
4-Treatment: Specific Measures
  • Identify specific therpaies used in the treatment of pulmonary arterial hypertension
  • Describe the role of calcium channel blockers in the management of pulmonary arterial hypertension
  • Describe a satisfactory therapeutic response in vasoreactivity testing
  • Describe the mechanism of action and role of endothelin receptor antagonists, phosphodiesterase-5 inhibitors, and guanylate cyclase stmulators in the management of pulmonary hypertension
  • Describe the treatment strategies and goals for patients with pulmonary arterial hypertension at initial and follow-up evaluations
  • Describe the prognosis and treatment decisions to consider in patients with pulmonary arterial hypertension and cardiopulmonary comorbidiites
  • Describe how to manage patients with progressive pulmonary hypertension
  • Describe when a patient should be referred to a pulmonary hypertension specialty center
5-Group 1 Disorders
  • Define group 1 pulmonary hypertension
  • Identify drugs and toxins associated with pulmonary arterial hypertension
  • Identify connective tissue diseases associated with pulmonary arterial hypertension
  • Describe the association of HIV with pulmonary arterial hypertension and the general management in such cases
  • Describe how to diagnose and manage pulmonary arterial hypertension associated with portal hypertension, including those underlying liver transplantation
  • Describe the prognosis, evaluation, and therapies for patients with pulmonary arterial hypertension assocaited with adult congenital heart disease
  • Describe the long-term course for patients with idiopathic pulmonary arterial hypertension versus those with Eisenmenger syndrome
  • Describe the etiologies, prognosis, evaluation, and therapies for pulmonary arterial hypertension associated with signs of venous/capillary involvement (pulmonary venoocclusive disease)
6-Group 2-5 Disorders
  • Define group 2 through 5 pulmonary hypertension disorders
  • Describe the pathophysiology, evaluation, and treatment of group 2 pulmonary hypertension
  • Identify disease states associated with group 3 pulmonary hypertension
  • Describe how pulmonary vascular resistance affects patient outcomes
  • Describe the pathophysiology, evaluation, and treatment of group 3 pulmonary hypertension
  • Describe the role of right heart catherization in the evaluation of patients with group 3 pulmonary hypertension
  • Describe the pathophysiology, evaluation, and treatment of group 4 pulmonary hypertension
  • Define chronic thromboembolic pulmonary disease
  • Identify risk factors associated with chronic thromboembolic pulmonary hypertension (CTEPH)
  • Describe the role of anticoagulation in chronic thromboembolic pulmonary disease with and without pulmonary hypertension
  • Describe the treatment options available for chronic thromboembolic pulmonary hypertension (CTEPH)
  • Identify various group 5 pulmonary hypertension disorders
  • Describe the pathophysiology, evaluation, and treatment of group 5 pulmonary hypertension
Contributors: Nandan Anavekar, MBBCh; Mahmoud Ismayl, MD; Khalid Saeed Al-Asad, MD; Adnan Halboni, MD; Adolfo Martinez Salazar, MD; Anthony Kashou, MD
Last updated: January 2023.
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GCU Education Team
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