portal hypertension


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Related to portal hypertension: ascites

por·tal hy·per·ten·sion

hypertension in the portal system as seen in cirrhosis of the liver and other conditions causing obstruction to the portal vein.
Farlex Partner Medical Dictionary © Farlex 2012

hypertension

High blood pressure Cardiovascular disease An abnormal ↑ systemic arterial pressure, corresponding to a systolic BP of > 160 mm Hg and/or diastolic BP of 95 mm Hg and graded according to intensity of ↑ diastolic BP; HTN affects ± 60 million in the US Workup Evaluation of HTN requires clinical Hx for Pt, family Hx, 2 BP determinations, funduscopy, ID of bruits in neck & abdominal aorta, evaluation of peripheral edema, peripheral pulses and residual neurologic defects in stroke victims, chest films to determine cardiac size and lab parameters to rule out causes of secondary HTN Risk factors Race–blacks more common, ♂, family history of HTN, obesity, defects of lipid metabolism, DM, sedentary lifestyle, cigarette smoking, electrolyte imbalance–eg, ↑ sodium, phosphorus, ↓ potassium, tin Treatment Diet–eg, sodium restriction, ↓ calories, alcohol and cigarettes–the weight gain accompanying smoking cessation tends to offset the minimal ↓ in BP, calcium supplements, lifestyle manipulation–eg, biofeedback, ↑ exercise; antihypertensives–eg, diuretics–benzothiadiazines, loop diuretics, potassium-sparing diuretics, sympatholytic agents–central and peripheral-acting α-adrenergics, β-adrenergics, mixed α- and β-blockers, direct vasodilators, ACE inhibitors–the preferred agent to use ab initio, dihydropiridine CCBs. See ACCT, ACE inhibitor, Borderline hypertension, Borderline isolated systolic hypertension, Calcium channel blocker, Drug-induced hypertension, Essential hypertension, Exercise hypertension, Familial dyslipemic hypertension, Gestational hypertension, Idiopathic intracranial hypertension, Isolated systolic hypertension, Malignant hypertension, MRC, Obetension, Paradoxic hypertension, Pill hypertension, Pregnancy-induced hypertension, Pseudohypertension, Pulmonary hypertension, Refractory hypertension, Renovascular hypertension, SHEP, STOP-Hypertension, TAIM, TOHP-1, TOMHSTyramine hypertension, White coat hypertension.
Hypertension
Class I–mild Diastolic pressure 90-104 mm Hg
Class II–moderate Diastolic pressure 105-119 mm Hg
Class III–severe Diastolic pressure > than 120 mm Hg
Hypertension types
Essential hypertension Idiopathic HTN The major form comprising 90% of all HTN
Malignant hypertension A sustained BP > 200/140 mm Hg, resulting in arteriolar necrosis, most marked in the brain, eg. cerebral hemorrhage, infarcts, and hypertensive encephalopathy, eyes, eg papilledema and hypertensive retinopathy and kidneys, eg acute renal failure and hypertensive nephropathy; if malignant HTN is uncorrected or therapy refractory, Pts may suffer a hypertensive crisis in which prolonged high BP causes left ventricular hypertrophy and CHF
Paroxysmal hypertension Transient or episodic waves of ↑ BP of any etiology, punctuated by periods of normotension, typical of pheochromocytoma
Portal hypertension ↑ portal vein pressure caused by a backflow of blood through splenic arteries, resulting in splenomegaly and collateral circulation, resulting in esophageal varices and/or hemorrhoids; PH may be intra- or extrahepatic, and is often due to cirrhosis, or rarely portal vein disease, venous thrombosis, tumors or abscesses
Pulmonary hypertension A condition defined as a 'wedge' systolic/diastolic pressure > 30/20 mm Hg–Normal: 18-25/12-16 mm Hg, often secondary to blood stasis in peripheral circulation, divided into passive, hyperkinetic, vasoocclusive, vasoconstrictive and secondary forms. See Pulmonary HTN.
Renovascular hypertension see there.
Secondary hypertension
Aging
Cardiovascular Open heart surgery, coarctation of aorta, ↑ cardiac output–anemia, thyrotoxicosis, aortic valve insufficiency
Cerebral ↑ Intracranial pressure
Endocrine Mineralocorticoid excess, congenital adrenal hyperplasia, glucocorticoid excess, eg Cushing syndrome, hyperparathyroidism, acromegaly
Gynecologic Pregnancy, oral contraceptives
Neoplasia Renin-secreting tumors, pheochromocytoma
• ↓ Peripheral vascular resistance AV shunts, Paget's disease of bone, beri-beri
Renal disease Vascular, parenchymal
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

por·tal hy·per·ten·sion

(pōr'tăl hī'pĕr-ten'shŭn)
Elevation of pressure in the hepatic portal circulation due to cirrhosis or other fibrotic change in liver tissue; when pressure exceeds 10 mmHg, a collateral circulation may develop to maintain venous return from structures drained by the portal vein; engorgement of collateral veins can lead to esophageal varices and, less often, caput medusae.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012

portal hypertension

Increased blood pressure in the PORTAL VEIN, that carries blood from the intestines and spleen to the liver. The commonest cause is CIRRHOSIS of the liver. The rise in pressure in the veins at the lower end of the oesophagus causes them to become stretched and irregular (varicose) and there is a real danger of severe bleeding from these oesophageal varices. This can be controlled by the use of balloons inserted into the oesophagus and then inflated. Injections of hardening solution into the varices to close them off (sclerotherapy) may be helpful. A blood shunting operation is sometimes performed.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005

Portal hypertension

Portal hypertension forces the blood flow backward, causing the portal veins to enlarge and the emergence of bleeding varices across the esophagus and stomach from the pressure in the portal vein. Portal hypertension is most commonly caused by cirrhosis, but can also be seen in portal vein obstruction from unknown causes.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.

por·tal hy·per·ten·sion

(pōr'tăl hī'pĕr-ten'shŭn)
Elevation of pressure in the hepatic portal circulation due to cirrhosis or other fibrotic change in liver tissue.
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive ?
Concerning indirect biomarkers, the performance of the majority of these scores are well investigated and validated for the diagnosis of cirrhosis rather than for the assessment of portal hypertension. Among indirect biomarkers, platelet count is probably the routinely used test able to identify patients with portal hypertension in cACLD [52].
In our study, 45 patients had a negative EGD study for any active bleeding or signs of portal hypertension: esophageal varices, gastric varices, or portal hypertension gastropathy.
Overall, we observed a statistically significant negative correlation of moderate strength between the relative change in RLE, possibly indicative of hepatic inflammation and fibrosis [16] and spleen volume, potentially indicative of portal hypertension [17, 18].
Portal pressure measurements are the primary diagnostic approach to establish the anatomic pathogenesis of portal hypertension [11].
Lerut, "Vaginal bleeding complicating portal hypertension: A particular entity--Report of two cases and review of the literature," Transplant International, vol.
In this prospective, exploratory study, we assessed the accuracy of noninvasive fibrosis biomarkers and MRE shear wave velocity for the diagnosis of fibrosis and portal hypertension in a cohort of hepatitis C (HCV) and/or human immunodeficiency virus- (HIV-) infected liver disease patients.
Bosch, "Non-invasive diagnostic and prognostic evaluation of liver cirrhosis and portal hypertension," Disease Markers, vol.
However, noncirrhotic left portal hypertension due to extrinsic compression of the portal vein and partial thrombosis of the splenic vein, with bleeding from an isolated gastric varix secondary to testicular cancer, has not been described before [8].
In addition, she has chronic liver disease with portal hypertension. She was born by C-section at 30 weeks' gestation to a 37-year-old G4P2A1 mother with pregnancy complicated by late prenatal care--last 6 weeks of pregnancy.
The risk of rupture ranges from 2% to 10% [1, 5-7] and risk increases in presence of portal hypertension, in liver transplant patients, and during pregnancy [1, 5, 8, 9].
Gastroesophageal varices are present in almost half of patients with cirrhosis at the time of diagnosis6 with incidence of 7% per year.7,8 Gastric varices are less prevalent than oesophageal varices and are present in 5%-33% of patients with portal hypertension and the reported incidence of bleeding from gastric varices is about 25% in 2 years compared to 64% in oesophageal varices.9 Bleeding from gastric varices is generally more severe having more transfusion requirements and is associated with higher morbidity and mortality than oesophageal varices.10