Pulmonary hypertension causes: Difference between revisions

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| '''Environmental'''
|bgcolor="Beige"| [[ High altitude sickness|High Altitude(chronically)]]
|bgcolor="Beige"| [[High altitude sickness|High Altitude (chronically)]]
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| '''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]]).
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=== Causes in Alphabetical Order ===
=== Causes in Alphabetical Order ===


{{MultiCol}}
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* [[Alveolar capillary dysplasia|Alveolar capillary dysplasia with misalignment of pulmonary veins]]
* [[Alveolar capillary dysplasia|Alveolar capillary dysplasia with misalignment of pulmonary veins]]
* [[Atrial Septal Defects]]
* [[Atrial Septal Defects]]

Revision as of 20:23, 14 May 2014

Pulmonary Hypertension Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pulmonary hypertension from other Diseases

Epidemiology & Demographics

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Diagnosis

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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 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.

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, benfluorex, dexfenfluramine, fenfluramine, toxic rapeseed oil, benfluorex,
Likely: Amphetamines, L-tryptophan, methamphetamine
Possible: Cocaine, phenylpropanolamine, pergolide, St John's wort, chemotherapeutic agents, SSRI
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,Endogin...)
  3. Drug and toxin induced.
  4. Connective tissue diseases
  5. HIV
  6. Portal hypertension
  7. Congenital heart diseases
  8. Schistosomiasis
  9. Chronic hemolytic anemia.
  10. Persistent pulmonary hypertension of the newborn

Class 2: Pulmonary Venous Hypertension or pulmonary hypertension owing to left heart disease

  1. Systolic dysfunction.
  2. Diastolic dysfunction.
  3. Valvular disease.

Class 3: Pulmonary Hypertension associated with disorders of the respiratory system and/or Hypoxemia

  1. Chronic obstructive pulmonary disease.
  2. Interstitial lung disease
  3. Pulmonary diseases with mixed restrictive and obstructive patterns.
  4. Obstructive sleep apnea.
  5. High altitude(chronically).
  6. Developmental abnormalities.

Class 4: Pulmonary Hypertension due to chronic thrombotic and/or embolic disease

Class 5: Pulmonary Hypertension due to disorders directly affecting the pulmonary vasculature

  1. Hematologic disorders: Myeloproliferative disorders, splenectomy, polycythemia vera.
  2. Systemic disorders: Sarcoidosis, Langerhans cell histiocytosis, neurofibromatosis, vasculitis.
  3. Metabolic disorders: Glycogen storage diseases, Gaucher disease, thyroid disease.
  4. Miscellaneous: Tumor obstruction, fibrosing mediastinitis, chronic renal failure on dialysis.

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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