Question

D. D. is a 66 year-old female suffering from shortness of breath. She smoked 2 packs a day until she quit 2 years ago. She has a history of bronchiolitis, hyperinflated lungs, pulmonary edema, and syncope. Her primary care practitioner suspects she also has pulmonary hypertension (PH). After examination, D. D. has a PAP of 35mmHg and mild CHF.

1. What is pulmonary hypertension and how could D. D. have developed PH?
2. How does her history fit in with her new diagnosis?

Answer 1

Answer

Pulmonary hypertension

It means that it is a less common type of high blood pressure that affects arteries in the lungs.

Pulmonary hypertension occurs when the pressure in the pulmonary circulation becomes abnormaly elevated.

Causes

Primary pulmonary hypertension

No underlying causes

Inherited genetic predisposition

Secondary pulmonary hypertension

COPD

Pulmonary emboli

Connective tissue disorder such as scleroderma

Upper airway obstructed during sleep

Obesity with reduced ability to breath

Pulmonary fibrosis

Left side heart failure

Congenital heart disease.

how could D. D. have developed PH?

D.D have developed hypertension because of smoking habit ,She had habit of smoking 2packs until she quit smoking 2year back

Reason

The cigarette smoking highly increases pulmonary hypertension mainly due to the reactive nitrogen species and consequent oxidative vascular damages.

The cigarette smoking also have the greatest contributor to the development of chronic obstructive pulmonary disease (COPD), chronic bronchitis and emphysema, which are diseases correlated with secondary pulmonary hypertension. Therefore, smokers who develop pulmonary hypertension are likely to also suffer from other lung conditions.

Here she had the history smoking 2year back this predisposing factor induced any of the respiratory diseases thus leads to pulmonary hypertension.

How does her history fit in with her new diagnosis?

Here D.D have the past medical history of bronchiolitis,hyperinflation lungs,pulmonary hypertension these closely linked with development of secondary pulmonary hypertension

In above mentioned disease like bronchiolitis--it means that it is a inflammatory disease condition which affect over respiratory system which may result pulmonary congestion

Hyperinflation of lungs-it occurs when the air trapped with in the lungs due to chronic smoking or any other respiratory disease.

COPD-it is a group of lung disorder characterized by the presence of chronic bronchitis and emphysema.

Due to her smoking habit she may suffered above respiratory disease and there by the medical history fit her new diagnosis.