Pulmonary Arterial Hypertension – Part 1 | Harrison Simplified скачать в хорошем качестве

Pulmonary Arterial Hypertension – Part 1 | Harrison Simplified

Pulmonary hypertension (PH) is a complex but high-yield topic in internal medicine — and understanding it properly can completely change how you approach patients. In Harrison Simplified – Part 1, we build PH from the ground up in a clear, clinical, step-by-step way, based on Harrison’s Principles of Internal Medicine, 22nd Edition. 0:00 – 2:25 Introduction to Pulmonary Hypertension (PH) • Disease complexity • Shift in understanding PH • 🚩 Average 2-year delay in diagnosis 2:25 – 5:18 Redefining PH: Hemodynamic Definition • Why the definition changed 5:18 – 9:39 Pathobiology: The “Cancer-Like” Nature of PH • Apoptosis resistance • Uncontrolled vascular cell proliferation • Warburg effect (metabolic shift) • Plexiform lesions Note: The pathobiology section focuses on high-yield concepts to help you understand the disease mechanism in a practical way, f anyone would like a more detailed explanation, please let me know in the comments. 9:39– 13:04 Genetics of PH • BMPR2 mutation (most common heritable cause) • EIF2AK4 → PVOD • Why genetic distinction matters clinically 13:04 – 15:35 Systemic Effects of PH • Cardiorenal syndrome • Congestive hepatopathy / cardiac cirrhosis • Skeletal muscle changes (sarcopenia, fiber shift) 15:35– 25:10 Clinical Presentation & Initial Evaluation • Dyspnea, fatigue, syncope ( red flag) • Loud P2 on exam • Echo (TR caveats) • 6-minute walk test • CPET • PFTs (DLCO) • CT imaging • Sleep study for all patients • Methamphetamine history • BNP levels 25:16 – 27:59 Ruling Out Impostors + Gold Standard Diagnosis • Right Heart Catheterization (RHC) – Pre-capillary – Isolated post-capillary – Combined • Vasoreactivity testing 28:15 – 36:59 Classification of PH (WSPH) • Group 1: PAH – Changing demographics – Heritable PH – CTD-associated PH – HIV, schistosomiasis, Portopulmonary HTN • Group 2: Left heart disease • Group 3: Lung disease/hypoxia • Group 4: CTEPH (⚠ potentially curable — don’t miss) • Group 5: Unclear / Multifactorial Mechanisms” 🎯 Designed for residents, medical students and junior doctors who want real understanding