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Cardiovascular Disability Updating the Social Security Listings (2010) / Chapter Skim
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11 Pulmonary Hypertension
Pages 183-190

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From page 183...
... This critical circulation of blood through the vessels of the lungs -- the pulmonary arteries, capillaries, and veins -- normally occurs at much lower pressures than blood flow through the systemic circulation to the rest of the body. The normal pulmonary artery systolic pressure is 20 mm Hg or less, and the normal mean (average)
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From page 184...
... Pulmonary hypertension is considered present when the mean pulmonary artery pressure is greater than 25 mm Hg at rest. Pulmonary arterial hypertension is a more specific diagnostic term that requires a pulmonary capillary wedge pressure of 15 mm Hg or less with a pulmonary vascular
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From page 185...
... The velocity of tricuspid regurgitation can be measured using Doppler echocardiography, and this can then be used to estimate the systolic pulmonary artery pressure. This estimated pressure correlates with the measured pressure, but the mean pulmonary artery pressure, the pulmonary capillary wedge pressure, and the pulmonary vascular resistance cannot be estimated with echocardiography.
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From page 186...
... All drugs used to lower pulmonary artery pressures may also lower systemic blood pressures. Endothelin antagonists may cause liver damage.
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From page 187...
... cor pulmonale demonstration of elevated listings pulmonar y ar tery pressure No Yes Other hear t disease or pulmonar y capillar y Evaluate under wedge pressure ≥ 20 mm Hg? appropriate hear t disease listings No Yes Mean pressure ≥ 40 mm Hg or Meets listing Pulmonar y vascular resistance ≥ 6 Wood units criteria No Yes Meets listing Continuous parenteral therapy?
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From page 188...
... ; or • Mean pulmonary artery pressure between 25 and 39 mm Hg; or • Pulmonary vascular resistance above 3 and below 6 Wood units. AND Evidence of marked functional disability provided by either of the following: • An exercise capacity of less than 5 metabolic equivalents of task; or • Three or more hospital admissions within a consecutive 12-month period to treat right heart failure or pulmonary hypertension.
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From page 189...
... 2009. ACC/AHA 2009 expert consensus document on pulmonary hyper tension: A report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collabo ration with the American College of Chest Physicians, the American Thoracic Society, Inc., and the Pulmonary Hypertension Association.
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Key Terms

  • pulmonary artery
  • artery pressure
  • mean pulmonary
  • pulmonary vascular
  • pulmonary arterial

  • arterial hypertension
  • functional limitations
  • vascular resistance
  • wedge pressure
  • primary pulmonary

  • pulmonary capillary
  • cor pulmonale
  • functional status
  • wood units
  • heart disease

  • capillary wedge
  • heart catheterization
  • lung disease
  • moderate pulmonary
  • listing pulmonary

  • current listing
  • marked functional
  • heart failure
  • artery pressures
  • specific diagnostic

  • disability criteria
  • continuous intravenous
  • mean pressure
  • exercise testing
  • expert consensus


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