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.

Citing scholarly resources, answer the following questions:

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

In addition to the two questions above, select ONE other question from the list below to complete your discussion post. Be sure to cite the sources of your information and clearly identify which supplemental question you chose to answer.

1. How many patients are suffering from COPD in the United States? Do COPD sufferers die of respiratory causes or other causes? (Be sure to cite the data.)
2. What two separate diseases are the main COPD diseases? Give background on each disease.
3. How does COPD correlate with left ventricular pressure and primary heart failure?
4. What are the three types of bronchodilators, and how do they function to alleviate the symptoms of COPD? What are other possible treatments for COPD?
5. Through which mechanism does bronchiolitis cause destruction of alveoli? Is emphysema genetic? Can environmental factors increase the risk of emphysema? Why or why not?
6. Is lung transplantation a solution for emphysema? Can new technology be useful in the treatment of emphysema? Why or why not?

comment 1

1. What is pulmonary hypertension and how could D.D. have developed PH?

According to the textbook, pulmonary hypertension is described as “a sustained increase in pulmonary artery pressure above 25 mm Hg systolic resting and above 30 mm Hg systolic with exercise” (Banasik & Copstead, 2019). For some cases of pulmonary hypertension, the systolic pressures may be high as 60 to 110 mm Hg. In addition, it results from conditions that increase the resistance of pulmonary vasculature. Disorders that reduce the total coss-sectional area of the lung increase resistance and promote pulmonary hypertension. On the other hand, DD developed PH due to smoking; Cigarette smoking highly increases pulmonary hypertension mainly due to the reactive nitrogen species and consequent oxidative vascular damages, as concluded by the authors of this article. In addition, smoking is the greatest contributor to the development of chronic obstructive pulmonary disease (BioNewsServices).

2. How does her history fit in with her new diagnosis?

D.D has history bronchiolitis, hyperinflated lungs, pulmonary edema, and Syncope. Her history fits in with pulmonary hypertension because according to the textbook, common and signs and symptoms of pulmonary hypertension are dyspnea (60 % of cases), syncope, chest pain, and jugular venous distension (Banasik & Copstead, 2019).

References

Banasik J. L. & Copstead, L. C. (2019). Pathophysiology (6th ed.). Elsevier, Inc.

Silva, P. (2019, September 10). Pulmonary Hypertension and Smoking. Retrieved July 7, 2020, from https://pulmonaryhypertensionnews.com/pulmonary-hy…

comment 2

What is pulmonary hypertension and how could D. D. have developed PH?

Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. According to our textbook, “Pulmonary hypertension is defined as a sustained increase in pulmonary artery pressure above 25 mm Hg systolic resting and above 30 mm Hg systolic with exercise. In some cases of pulmonary hypertension, systolic pressures may be as high as 60 to 110 mm Hg.” (Banasik & Copstead, 2019). There are two types of pulmonary hypertension; primary and secondary. Primary hypertension is idiopathic which basically means we still don’t know what causes it to happen. The elevation of blood pressure occurs without any type of evidence from other diseases. Primary hypertension is the most common for of hypertension. Secondary hypertension is associated to a specific identifiable pathology, condition, or disease. An increased pulmonary blood flow, increased resistance to blood flow, and increased left atrial pressure are the three major mechanisms resulting in pulmonary hypertension.

D.D. could have developed PH by her smoking that was 2 packs per day. So if my math is correct D.D would approximately smoke about 730 packs a year! One of the causes of emphysema (obstruction from increased pressure outside the lumen) is smoking more than 70 packs a year. D.D has well enough surpassed this statistic and the smoking along with dyspnea, has caused the PH

How does her history fit in with her new diagnosis?

D.D history plays a crucial role with her new diagnosis because all the signs and symptoms add up. According to our textbook, ” Patients may also experience syncope, increasing dyspnea, chest pain on exertion, fatigue, hemoptysis, and pulmonary edema.” (Banasik & Copstead, 2019). This can ultimately lead to cor pulmonale (right-sided heart enlargement due to primary lung disease). Also D.D PAP came back 35mmHg which the range for PH is usually seen from 20-30.

Reference:

Banasik J. L. & Copstead, L. C. (2019). Pathophysiology (6th ed.). Elsevier, Inc.

Pulmonary hypertension. (2020, March 20). Retrieved from https://www.mayoclinic.org/diseases-conditions/pul…