Pulmonary Arterial Hypertension – Part 1 | Harrison Simplified

Описание: 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