Exposicion hipertension pulmonar
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HIPERTENSIÓN ARTERIAL PULMONAR
PEDIATRIA
JHONATAN ALEXANDER BECERRA DIAZ
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• La hipertensión pulmonar (HTP) se define como la existencia de una presión media en la arteria pulmonar (PAPm) mayor de 25 mmHg en reposo o de más de 30 mmHg durante el ejercicio.
Definición
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CLASIFICACION
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CLASIFICACION
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ELEMENTOS DE HETEROGENEIDAD EN PEDIATRIA
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EPIODEMIOLOGIA
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EPIODEMIOLOGIA
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EPIODEMIOLOGIA
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Hipertensiónpulmonar primaria
Vasoconstricción Remoderación de la
pared vascular Trombosis
Aumento
resistencia
vascular
pulmonar
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REMODELACION DE LA PARED VASCULAR
• Mayor proliferacion de la matriz extracelular (colageno,elastina,fibronectina y tenascina).
• Aumento en la produccion de angiopoyetina 1 , Tie-2/ TGF/cels mesenquimales-pericitos o cels musculares lisas
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FISIOPATOLOGIA
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CARDIOPATIAS CONGENITAS
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HAP FAMILIARLa HAP es hereditaria en el 6-10%
25% de HAPI y 15% de HAP por tóxicos también mutaciones en BMPR2
Nueva clasificación sustituye "familiar" por "heredable".
Heredable = HAP familiar ( con/sin mutaciones identificadas) + HAP esporádica con mutaciones
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CONCLUSIONES
los hallazgos confirman que este medicamento es eficaz en el manejo de la hipertensión arterial pulmonar: sea a corto, mediano y largo plazo, mostrando a los niños buena tolerancia al sindenafil.
Por otra parte, el ecocardiograma fue un procedimiento seguro y accesible que permitió conocer la severidad de la hipertensión pulmonar
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BIBLIOGRAFIA– Inés Raposo-Sonnenfeld, Isabel Otero-González, Marina Blanco-Aparicio, Ángela
Ferrer-Barba, Constancio Medrano-López. Tratamiento con sildenafilo y/o bosentán en niños y jóvenes con hipertensión arterial pulmonar idiopática y síndrome de Eisenmenger. Rev Esp Cardiol. 2007;60:366-72. - Vol. 60 Núm.04
– Abrams D, Schulze-Neick I, Magee AG. Sildenafil as a selective pulmonary vasodilator in childhood primary pulmonary hypertension. Heart. 2000
– SÁENZ C, SÁNCHEZ V, VELÁZQUEZ M T, TELLO R, GÓMEZ M, DELGADO J, et al. Guías de práctica clínica de la Sociedad Española de Cardiología en tromboembolismo e hipertensión pulmonar. Rev Esp Cardiol 2001.
– Díaz CR. Hipertensión pulmonar en niños. En: Reyes MA, Aristizábal Duque G, Leal Quevedo FJ. Neumología pediátrica. 4 ed.Colombia: Médica Internacional, 2001.
– García ME, Ibarra RI, Pérez NJL, Tejero MI, Espósito MJF, Suárez LJ et al. Sildenafilo en el tratamiento de la hipertensión pulmonar. An Esp Pediatr. 2003.
– Cintya Edith León , Mayra P. Arteaga, José Iglesias L., Isabel Bernárdez Z. Sildenafil en el tratamiento de la hipertensión pulmonar en los recién nacidos. Revista mexicana de pediatria, nov. 2014
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