The Right Ventricle in Pulmonary Hypertension: John Greenwood

Jan 3, 2017

John Greenwood, an expert in pulmonary hypertension and heart-lung interactions, explores the devastating impact of pulmonary hypertension on cardiac function. He discusses the clinical heart-lung interactions, identifies high-risk patients, and shares critical management strategies. The podcast covers the causes and exacerbation of acute pulmonary hypertension, the often-overlooked right ventricle, and the effects of mechanical ventilation. It also delves into the differences between the left and right ventricles, the impact on coronary blood flow, and the use of pulmonary artery catheters.

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Introduction

00:00 • 3min

Heart-Lung Interactions and Identification of Patients at Risk in Pulmonary Hypertension

03:19 • 2min

Monitoring Patients After RSI and the Effects of Mechanical Ventilation on the Lung and Pulmonary Vasculature

05:23 • 2min

Analyzing the Impact of Pulmonary Hypertension on the Right Ventricle

07:45 • 19min

Use of Pulmonary Artery Catheters, Coronary Perfusion Pressure, and COPD Exacerbations

26:16 • 3min

John Greenwood takes a broad view on pulmonary hypertension and explores the heart-lung interactions that occur in this disease process. Pulmonary hypertension commonly occurs when managing a patient with an acute critical illness. Pulmonary hypertension has a devastating impact on cardiac function. Whilst we recognise the disease itself, we don't recognise the ‘upstream’ effects. John explains how it is these effects that may be causing the patient to crash. John, in this talk, helps you to understand the clinical heart-lung interactions affected by pulmonary hypertension and the effect on the right ventricle. He educates you on identifying patients at high risk for pulmonary hypertension, and finally he discusses critical management strategies for patients with pulmonary hypertension. In the ICU, causes of acute pulmonary hypertension are evident daily. Microcirculatory of the lung has a strong impact on what the pulmonary pressures are. Therefore, conditions such as pneumonia, ARDS and pulmonary oedema will all lead to pulmonary hypertension. The condition can then be exacerbated by the treatments offered – namely mechanical ventilation! This brings John to the right ventricle. John explains why he feels the right ventricle is too often overlooked. He describes the form and function of the right ventricle and how it often fails in the case of pulmonary hypertension. The pumping function of the muscle does not have the necessary components to overcome high pressures as they are encountered in this disease. Finally, John provides his thoughts on the management of pulmonary hypertension, keeping in mind the importance of the right ventricle. Through his presentation he will convince you that pulmonary hypertension is common. By remembering that the right ventricle is sensitive, by judicious use of echocardiography and by proper resuscitation, John will help you treat patients with pulmonary hypertension.

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