PULMONARY

HYPERTENSION
“High Blood Pressure in the Heart-Lung System”
Muhammad Chairil Riskyta Akbar, S. Ked
10542062915

Pembimbing :
Dibawakan dalam Tugas Kepaniteraan Klinik dr. Sumarni, Sp. JP
Bagian Ilmu Penyakit Dalam Fakultas Kedokteran
Universitas Muhammadiyah Makassar
 WHOM DOES IT AFFECT (?)

WORLD  25 Million Cases  Screening Distribution

Prognosis  Dubia Malam (Treatment Immediately)
Developed Developing
>> US  Left Heart Failure (II) Schistosomiasis
African-American  Sickle Cell
Anemia
(ACCF/AHA, 2009)
IN US  Exact Unknown  Large Screening
Prevalence  10/1000
Prevalence. .
Mortality  +/- 15.000/ year
Age Gender
Average 25-35 y.o ♀>♂
(ACCF/AHA, 2009)
Indonesia  Awareness ↓
80 % Developing Country
(NLM, 2012)
PULMONARY HYPERTENSION
1. Definition
Pulmonary hypertension is high blood pressure in the arteries going to the
lung. If the pulmonary arterial pressure exceeds about 40/20 mm Hg or the
average pressure exceeds 25 mm Hg, then pulmonary hypertension is
present.
(PHA, 2017)

2. Etiologi
1. CHD
2. HIV
3. HHT
4. Liver Disease
5. Methamphetamine Use
6. Schistosomiasis
7. Scleroderma
8. Sickle Cell Disease
 3. PATHOPHYSIOLOGY
WHO Group 1: Pulmonary Arterial Hypertension (PAH)
1. Idiopathic PAH (IPAH)
2. Heritable PAH
3. Diseased association

Treatment Options, No Cure

WHO Group 2: Pulmonary Hypertension Due to Left Heart Disease

Most Common
 3. PATHOPHYSIOLOGY (2)
WHO Group 3: Pulmonary Hypertension Due to Lung Disease
1. PPOK
2. Pulmonary fibrosis
3. High Altitude

WHO Group 4: Pulmonary Hypertension Due to Chronic CTEPH  Surgery

Blood Clots in the Lungs

WHO Group 5: Pulmonary Hypertension Due to Unknown Causes

(PHA. 2017)
 4. Common Symptoms Experienced by People
With PH
The most common symptoms of PH can also be caused by other more common medical problems, such as asthma or chronic
obstructive pulmonary disease (COPD)

Therefore, diagnosing PH is difficult and requires a specialist.

(Brown LM. 2011)
5. Diagnosing Pulmonary Hypertension
Preliminary Tests
1. Blood Tests
2. Chest X-Rays
3. ECG
4. Echocardiogram
5. Exercise tolerance test
6. Pulmonary Function Tests

The Gold Standard for PH Diagnosis

1. Right-Heart Catheterization
2. Vasodilator Study (Acute Vasodilator Challenge)

(Medscape. 2018)
 6. TREATMENTS
Conventional Medical Therapies
1. Calcium Channel Blockers (CCB)
2. Digoxin
3. Diuretics
4. Oxygen
5. Warfarin
Oral Treatment Options
1. Endothelin Receptor Antagonists (ERAs)
2. Phosphodiesterase Inhibitors (PDE 5 Inhibitors)
3. Prostacyclin Analogue
Inhaled Treatment Options
Intravenous Treatment Options
Subcutaneous Treatment Options
Stem Cell Therapy
Lung Transplantation
REFERENCES
1. Badesch DB, Raskob GE, Elliott CG, Krichman AM, Farber HW, Frost AE, Barst RJ, Benza RL, Liou TG,
Turner M, et al. Pulmonary arterial hypertension: baseline characteristics from the REVEAL Registry. Chest
2010;137:376–387.
2. Brown LM, et al. Chest. 2011;140(1):19-26
3. https://phassociation.org/patients/aboutph/ diakses pada 14 Agustus 2019 Pukul 10.00 WITA
4. http://www.searo.who.int/entity/noncommunicable_diseases/media/non_communicable_diseases_hypertensi
on_fs.pdf diakses pada 14 Agustus 2019 Pukul 10.00 WITA
5. https://www.who.int/health-topics/hypertension/ diakses pada 14 Agustus 2019 Pukul 10.00 WITA
 SYUKRON 
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