Pulmonary hypertension is a common symptom of cardiovascular, renal and congenital disease.
Most cases in dogs are categorized as precapillary or postcapillary, which influences their diagnosis and treatment.
Pulmonary hypertension usually occurs as a result of endarteritis, resulting in narrowing of pulmonary arteries. Secondary complications of pulmonary hypertension include thromboembolism, pneumonitis, pneumonia and pulmonary effusion. As the disease progresses, intravascular pressure overload occurs in the right heart, leading to cor pulmonale, hepatomegaly and ascites.
- Primary lung diseases - Pulmonary interstitial fibrosis, acute respiratory distress syndrome, tracheal collapse, tracheal hypoplasia, bronchial carcinoma, pulmonary artery vascular hamartoma
- Parasites - Heartworm disease, Ehrlichia spp
- Congestive heart failure - Patent ductus arteriosus, mitral valve endocardiosis, endocarditis, dilated cardiomyopathy, atrial fibrillation, left atrial rupture, Ebstein's anomaly, Eisenmenger's syndrome
- Lungworms - e.g. Angiostrongylus spp
- Primary renal diseases - Acute kidney injury, chronic renal disease
- Cannabis toxicity
Diagnosis is based on presenting clinical signs, radiographs (which usually show right-sided cardiomegaly and distension of pulmonary arteries), ultrasonography, echocardiography, Doppler echocardiography and elevations in serum cardiac troponin, NT-proBNP and atrial natriuretic peptide levels.
Bronchoalveolar lavage may be required to eliminate other causes of pulmonary disease.
Adjunct therapy with drugs such as aminophylline may assist resolution of clinical signs.
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