Pulmonary hypertension causes: Difference between revisions

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===Life Threatening Causes===
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Pulmonary hypertension in itself is not a life threatening condition, but it is progressively fatal if left untreated. [[Pulmonary embolism]] and acute [[left heart failure]] are two causes of pulmonary hypertension that can be quickly fatal.
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Pulmonary hypertension itself is not a life threatening condition, but it is progressively fatal if left untreated. [[Pulmonary embolism|'''Pulmonary embolism''']] and [[left heart failure|'''acute left heart failure''']] are two causes of pulmonary hypertension that can be quickly fatal.


===Common Causes===
===Common Causes===
Line 34: Line 34:
=== Causes by Organ System ===
=== Causes by Organ System ===


{|style="width:70%; height:100px" border="1"
{| style="width:70%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[ASD|Atrial septal defect]], [[cor triatriatum]], [[left heart failure]], [[Fallot tetralogy]], [[persistent fetal circulation]], [[mitral valve stenosis]], [[mitral valve insufficiency]], [[ventricular septal defect]]   
| style="width:75%" bgcolor="Beige" ; border="1" | [[ASD|Atrial septal defect]], [[cor triatriatum]], [[left heart failure]], [[Fallot tetralogy]], [[persistent fetal circulation]], [[mitral valve stenosis]], [[mitral valve insufficiency]], [[ventricular septal defect]]   
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical / poisoning'''
|bgcolor="Beige"| [[Coal workers' pneumoconiosis]]
| bgcolor="Beige" | [[Coal workers' pneumoconiosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| [[Neurofibromatosis]], [[systemic lupus erythematosus]]
| bgcolor="Beige" | [[Neurofibromatosis]], [[systemic lupus erythematosus]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Drug and Toxin Side Effect'''
| '''Drug and Toxin Side Effect'''
|bgcolor="Beige"|  Definite: [[Aminorex]], [[Carfilzomib]], [[benfluorex]], [[dexfenfluramine]], [[Diethylpropion]], [[fenfluramine]], toxic [[rapeseed]] oil, [[benfluorex]], <br> Likely: [[Amphetamines]], L-[[tryptophan]], [[methamphetamine]] <br> Possible: [[Cocaine]], [[Lorcaserin]], [[Pegylated interferon alfa-2b]], [[phentermine]], [[phenylpropanolamine]], [[pergolide]],[[Protamine sulfate]],[[St John's wort]], [[chemotherapeutic agents]], [[SSRI]], [[Aprotinin]]
| bgcolor="Beige" |  Definite: [[Aminorex]], [[Carfilzomib]], [[benfluorex]], [[dexfenfluramine]], [[Diethylpropion]], [[fenfluramine]], toxic [[rapeseed]] oil, [[benfluorex]], <br> Likely: [[Amphetamines]], L-[[tryptophan]], [[methamphetamine]] <br> Possible: [[Cocaine]], [[Lorcaserin]], [[Pegylated interferon alfa-2b]], [[phentermine]], [[phenylpropanolamine]], [[pergolide]],[[Protamine sulfate]],[[St John's wort]], [[chemotherapeutic agents]], [[SSRI]], [[Aprotinin]]


|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[Pickwickian syndrome]]
| bgcolor="Beige" | [[Pickwickian syndrome]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| [[Thyroid diseases]]
| bgcolor="Beige" | [[Thyroid diseases]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| [[High altitude sickness|High Altitude (chronically)]]
| bgcolor="Beige" | [[High altitude sickness|High Altitude (chronically)]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Portal hypertension]]
| bgcolor="Beige" | [[Portal hypertension]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| [[Alveolar capillary dysplasia|Alveolar capillary dysplasia with misalignment of pulmonary veins]], [[cholesterol ester storage disease]], [[cystic fibrosis]], [[Gaucher disease]], Indian familial childhood cirrhosis<ref name="pmid23852284">{{cite journal| author=Nayak NC, Chitale AR| title=Indian childhood cirrhosis (ICC) & ICC-like diseases: the changing scenario of facts versus notions. | journal=Indian J Med Res | year= 2013 | volume= 137 | issue= 6 | pages= 1029-42 | pmid=23852284 | doi= | pmc=PMC3734708 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23852284 }} </ref>
| bgcolor="Beige" | [[Alveolar capillary dysplasia|Alveolar capillary dysplasia with misalignment of pulmonary veins]], [[cholesterol ester storage disease]], [[cystic fibrosis]], [[Gaucher disease]], Indian familial childhood cirrhosis<ref name="pmid23852284">{{cite journal| author=Nayak NC, Chitale AR| title=Indian childhood cirrhosis (ICC) & ICC-like diseases: the changing scenario of facts versus notions. | journal=Indian J Med Res | year= 2013 | volume= 137 | issue= 6 | pages= 1029-42 | pmid=23852284 | doi= | pmc=PMC3734708 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23852284 }} </ref>
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| [[Myeloproliferative disorders]], [[paroxysmal nocturnal haemoglobinuria]], [[polycythemia vera]], [[splenectomy]], [[sickle cell disease]]
| bgcolor="Beige" | [[Myeloproliferative disorders]], [[paroxysmal nocturnal haemoglobinuria]], [[polycythemia vera]], [[splenectomy]], [[sickle cell disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying cause
| bgcolor="Beige" | No underlying cause
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[ Kaposi's sarcoma-associated herpesvirus|HHV-8]], [[schistosoma japonicum]] and [[schistosoma mansoni]]
| bgcolor="Beige" | [[ Kaposi's sarcoma-associated herpesvirus|HHV-8]], [[schistosoma japonicum]] and [[schistosoma mansoni]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| [[Scoliosis|Idiopathic spinal scoliosis]]
| bgcolor="Beige" | [[Scoliosis|Idiopathic spinal scoliosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying cause
| bgcolor="Beige" | No underlying cause
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying cause
| bgcolor="Beige" | No underlying cause
   
   
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying cause
| bgcolor="Beige" | No underlying cause


|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[Diethylpropion]], monocrotaline,<ref name="pmid9776954">{{cite journal| author=Schultze AE, Roth RA| title=Chronic pulmonary hypertension--the monocrotaline model and involvement of the hemostatic system. | journal=J Toxicol Environ Health B Crit Rev | year= 1998 | volume= 1 | issue= 4 | pages= 271-346 | pmid=9776954 | doi=10.1080/10937409809524557 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9776954 }} </ref> [[phentermine]], [[radiation exposure]] (fibrosing [[mediastinitis]] and [[pulmonary fibrosis]]).
| bgcolor="Beige" | [[Diethylpropion]], monocrotaline,<ref name="pmid9776954">{{cite journal| author=Schultze AE, Roth RA| title=Chronic pulmonary hypertension--the monocrotaline model and involvement of the hemostatic system. | journal=J Toxicol Environ Health B Crit Rev | year= 1998 | volume= 1 | issue= 4 | pages= 271-346 | pmid=9776954 | doi=10.1080/10937409809524557 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9776954 }} </ref> [[phentermine]], [[radiation exposure]] (fibrosing [[mediastinitis]] and [[pulmonary fibrosis]]).
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| [[Idiopathic pulmonary hemosiderosis]], [[sarcoidosis]], [[primary pulmonary hypertension]], [[pulmonary fibrosis]], [[alveolar capillary dysplasia|alveolar capillary dysplasia with misalignment of pulmonary veins]], [[cystic fibrosis]], [[pulmonary embolism]], [[tropical pulmonary eosinophilia]], [[pulmonary capillary hemangiomatosis]], [[bronchiectasis]],[[bronchopulmonary dysplasia]], [[chronic obstructive pulmonary disease]], pulmonary alveolar microlithiasis,<ref name="pmid23741096">{{cite journal| author=Kashyap S, Mohapatra PR| title=Pulmonary alveolar microlithiasis. | journal=Lung India | year= 2013 | volume= 30 | issue= 2 | pages= 143-7 | pmid=23741096 | doi=10.4103/0970-2113.110424 | pmc=PMC3669555 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23741096 }} </ref> [[pulmonary fibrosis]], [[Langerhans cell histiocytosis]],[[interstitial lung disease]].
| bgcolor="Beige" | [[Idiopathic pulmonary hemosiderosis]], [[sarcoidosis]], [[primary pulmonary hypertension]], [[pulmonary fibrosis]], [[alveolar capillary dysplasia|alveolar capillary dysplasia with misalignment of pulmonary veins]], [[cystic fibrosis]], [[pulmonary embolism]], [[tropical pulmonary eosinophilia]], [[pulmonary capillary hemangiomatosis]], [[bronchiectasis]],[[bronchopulmonary dysplasia]], [[chronic obstructive pulmonary disease]], pulmonary alveolar microlithiasis,<ref name="pmid23741096">{{cite journal| author=Kashyap S, Mohapatra PR| title=Pulmonary alveolar microlithiasis. | journal=Lung India | year= 2013 | volume= 30 | issue= 2 | pages= 143-7 | pmid=23741096 | doi=10.4103/0970-2113.110424 | pmc=PMC3669555 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23741096 }} </ref> [[pulmonary fibrosis]], [[Langerhans cell histiocytosis]],[[interstitial lung disease]].
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[renal failure|Chronic renal failure]] on [[dialysis]]
| bgcolor="Beige" | [[renal failure|Chronic renal failure]] on [[dialysis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"|  [[Vasculitis]], [[Churg-Strauss syndrome]], [[sarcoidosis]], [[systemic sclerosis]], [[systemic lupus erythematosus]].
| bgcolor="Beige" |  [[Vasculitis]], [[Churg-Strauss syndrome]], [[sarcoidosis]], [[systemic sclerosis]], [[systemic lupus erythematosus]].
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Gaucher disease]], [[glycogen storage diseases]], [[scoliosis|idiopathic spinal scoliosis]],   
| bgcolor="Beige" | [[Gaucher disease]], [[glycogen storage diseases]], [[scoliosis|idiopathic spinal scoliosis]],   
|-
|-
|}
|}

Revision as of 15:24, 28 February 2018

Pulmonary Hypertension Microchapters

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Overview

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Differentiating Pulmonary hypertension from other Diseases

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Risk calculators and risk factors for Pulmonary hypertension causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ralph Matar; Mohamed Moubarak, M.D. [2]

Overview

Pulmonary hypertension can be classified into primary pulmonary hypertension (of unknown cause) which is currently known as idiopathic pulmonary arterial hypertension (IPAH) and secondary pulmonary hypertension due to another medical condition. The most common cause of pulmonary hypertension is left heart failure. Other common causes include HIV, systemic sclerosis, portal hypertension, congenital heart disease and sickle cell disease.[1]

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Pulmonary hypertension itself is not a life threatening condition, but it is progressively fatal if left untreated. Pulmonary embolism and acute left heart failure are two causes of pulmonary hypertension that can be quickly fatal.

Common Causes

The most common cause of pulmonary hypertension is left heart failure leading to pulmonary venous hypertension. Other Common causes of pulmonary arterial hypertension (PAH) include:

Idiopathic Pulmonary Arterial Hypertension

When none of the causes on this page can be found, the disease is termed idiopathic pulmonary arterial hypertension (IPAH).

Causes by Organ System

Cardiovascular Atrial septal defect, cor triatriatum, left heart failure, Fallot tetralogy, persistent fetal circulation, mitral valve stenosis, mitral valve insufficiency, ventricular septal defect
Chemical / poisoning Coal workers' pneumoconiosis
Dermatologic Neurofibromatosis, systemic lupus erythematosus
Drug and Toxin Side Effect Definite: Aminorex, Carfilzomib, benfluorex, dexfenfluramine, Diethylpropion, fenfluramine, toxic rapeseed oil, benfluorex,
Likely: Amphetamines, L-tryptophan, methamphetamine
Possible: Cocaine, Lorcaserin, Pegylated interferon alfa-2b, phentermine, phenylpropanolamine, pergolide,Protamine sulfate,St John's wort, chemotherapeutic agents, SSRI, Aprotinin
Ear Nose Throat Pickwickian syndrome
Endocrine Thyroid diseases
Environmental High Altitude (chronically)
Gastroenterologic Portal hypertension
Genetic Alveolar capillary dysplasia with misalignment of pulmonary veins, cholesterol ester storage disease, cystic fibrosis, Gaucher disease, Indian familial childhood cirrhosis[2]
Hematologic Myeloproliferative disorders, paroxysmal nocturnal haemoglobinuria, polycythemia vera, splenectomy, sickle cell disease
Iatrogenic No underlying cause
Infectious Disease HHV-8, schistosoma japonicum and schistosoma mansoni
Musculoskeletal / Ortho Idiopathic spinal scoliosis
Neurologic No underlying cause
Nutritional / Metabolic No underlying cause
Obstetric/Gynecologic No underlying cause
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity Diethylpropion, monocrotaline,[3] phentermine, radiation exposure (fibrosing mediastinitis and pulmonary fibrosis).
Psychiatric No underlying causes
Pulmonary Idiopathic pulmonary hemosiderosis, sarcoidosis, primary pulmonary hypertension, pulmonary fibrosis, alveolar capillary dysplasia with misalignment of pulmonary veins, cystic fibrosis, pulmonary embolism, tropical pulmonary eosinophilia, pulmonary capillary hemangiomatosis, bronchiectasis,bronchopulmonary dysplasia, chronic obstructive pulmonary disease, pulmonary alveolar microlithiasis,[4] pulmonary fibrosis, Langerhans cell histiocytosis,interstitial lung disease.
Renal / Electrolyte Chronic renal failure on dialysis
Rheum / Immune / Allergy Vasculitis, Churg-Strauss syndrome, sarcoidosis, systemic sclerosis, systemic lupus erythematosus.
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Gaucher disease, glycogen storage diseases, idiopathic spinal scoliosis,

Causes in Alphabetical Order


Causes by Clinical Classification

Class 1: Pulmonary arterial hypertension

  1. Idiopathic pulmonary arterial hypertension
  2. Heritable (BMPR2, ALK-1, ENG, SMAD9, CAV1, KCNK3)
  3. Drug and toxin induced

Class 2: Pulmonary hypertension due to left heart disease

  1. Left ventricular systolic dysfunction
  2. Left ventricular diastolic dysfunction
  3. Valvular disease
  4. Congenital/acquired left heart inflow/outflow tract obstruction and congenital cardiomyopathies

Class 3: Pulmonary hypertension due to lung diseases and/or hypoxia

  1. Chronic obstructive pulmonary disease
  2. Interstitial lung disease
  3. Other pulmonary diseases with mixed restrictive and obstructive pattern
  4. Sleep-disordered breathing
  5. Alveolar hypoventilation disorders
  6. Chronic exposure to high altitude
  7. Developmental lung diseases

Class 4: Chronic thromboembolic pulmonary hypertension

Class 5: Pulmonary hypertension with unclear multifactorial mechanisms

  1. Hematologic disorders: chronic hemolytic anemia, Myeloproliferative disorders, splenectomy,
  2. Systemic disorders: sarcoidosis, pulmonary histiocytosis, lymphangioleiomyomatosis
  3. Metabolic disorders: glycogen storage disease, Gaucher disease, thyroid disorders
  4. Miscellaneous: tumoral obstruction, fibrosing mediastinitis, chronic renal failure, segmental PH

References

  1. ↑ 1.0 1.1 Gladwin MT, Sachdev V, Jison ML, Shizukuda Y, Plehn JF, Minter K; et al. (2004). "Pulmonary hypertension as a risk factor for death in patients with sickle cell disease". N Engl J Med. 350 (9): 886–95. doi:10.1056/NEJMoa035477. PMID 14985486.
  2. ↑ 2.0 2.1 Nayak NC, Chitale AR (2013). "Indian childhood cirrhosis (ICC) & ICC-like diseases: the changing scenario of facts versus notions". Indian J Med Res. 137 (6): 1029–42. PMC 3734708. PMID 23852284.
  3. ↑ 3.0 3.1 Schultze AE, Roth RA (1998). "Chronic pulmonary hypertension--the monocrotaline model and involvement of the hemostatic system". J Toxicol Environ Health B Crit Rev. 1 (4): 271–346. doi:10.1080/10937409809524557. PMID 9776954.
  4. ↑ 4.0 4.1 Kashyap S, Mohapatra PR (2013). "Pulmonary alveolar microlithiasis". Lung India. 30 (2): 143–7. doi:10.4103/0970-2113.110424. PMC 3669555. PMID 23741096.


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