The original Kings of County - By Brian - May 21, 2016
"The most common cause of pulmonary hypertension in the U.S. is left-sided heart failure, but many cases of pulmonary hypertension remain undocumented. Pulmonary arterial hypertension is a specific category of pulmonary hypertension and is a relatively rare disease. In the ED, we often do not consider this disease in the differential diagnosis of dyspnea. And, definitive diagnosis is often delayed as right-sided heart catheterization is required.
When resuscitating a patient in respiratory distress secondary to pulmonary hypertension, there must be a delicate and dangerous balancing act to avoid right ventricle (RV) failure and hypotension. The most important concept to understand is that you cannot directly augment cardiac output (CO) due to fixed pulmonary vascular resistance, so you must try to prevent further hypoxemia, pulmonary vascular constriction, and reductions in CO..."