Pathology: Rightheart failure due to chronic pulmonary hypertension
Aetiology: Anycause of pulmonary hypertension.
Pulmonary vascular disease: acute pulmonary embolism, primarypulmonary hypertension, chronic pulmonary embolism, parasitic infection
Lung disease: COPD, asthma, pulmonary fibrosis,bronchiectasis
Chronic hypoventilation: motor neurone disease, myastheniagravis, kyphosis, scoliosis, OSA
Symptoms: Dyspnoea,fatigue, anorexia, weight loss
Signs: Peripheraloedema, raised JVP, right ventricular heave, cyanosis, tricuspid regurgitation,hepatomegaly, cyanosis
Investigations: ECG: Right ventricular hypertrophy andright axis deviation, P pulmonale.
Chest X-Ray: Right atrial enlargement, cardiomegaly
FBC: Polycythaemia.
ECHO: Right ventricular dysfunction, tricuspidregurgitation and estimation of right
sided pressures
Treatment: Treatthe underlying cause, oxygen if hypoxic, diuretics, heart-lung transplantation
Complications: Arrhythmia,liver failure
Prognosis: Poor,50% 5 year mortality
