2.15 Pulmonary Hypertension

Pulmonary system review for the USMLE Step 1 Exam

• Pulmonary hypertension is elevated blood pressure within the pulmonary arteries at rest, defined as a mean pulmonary artery pressure above 20 mmHg.
• Primary pulmonary hypertension is high blood pressure in the pulmonary arteries that is not caused by some underlying disease, while secondary pulmonary hypertension is high blood pressure caused by an underlying condition.
• Common underlying conditions for secondary pulmonary hypertension include heart failure, chronic thromboembolic disease, lung disease, and autoimmune disease.
• Pulmonary hypertension can lead to right heart failure and eventually death.
• Treatment for pulmonary hypertension involves treating the underlying disease and using drugs such as PDE-5 inhibitors, endothelin receptor antagonists, and prostacyclin to dilate the vessels in the lungs and lower the pressure within the pulmonary vessels.