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Portal hypertension

Author: John Reinus; Montefiore Medical Center.; Albert Einstein College of Medicine.; Henry Stewart Talks (Firm)
Publisher: London : Henry Stewart Talks, 2011.
Series: Henry Stewart talks., Biomedical & life sciences collection., Gastroenterology and hepatology.
Edition/Format:   eVideo : Clipart/images/graphics : EnglishView all editions and formats
Publication:Henry Stewart Talks.
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Material Type: Clipart/images/graphics, Internet resource, Videorecording
Document Type: Internet Resource, Computer File, Visual material
All Authors / Contributors: John Reinus; Montefiore Medical Center.; Albert Einstein College of Medicine.; Henry Stewart Talks (Firm)
OCLC Number: 698307446
Notes: Animated audio-visual presentation with synchronized narration.
Title from title information page (viewed Jan 24, 2011).
Description: 1 streaming video file (22 min.) : digital, SWF file, sound, color.
Contents: Portal hypertension causes regional circulatory derangements that result in extra- and intra-vascular volume overload and organ dysfunction --
Vascular tone is mediated by autonomic input and chemical mediators many of which are released by local vascular endothelium --
Intrahepatic portal hypertension develops as a result of anatomic changes in the cirrhotic liver that cause sinusoidal narrowing and loss of compliance --
Reflex SMA vasoconstriction and portosystemic shunting up-regulate VEGF eNOS and iNOS with resultant vasodilation --
There is secondary: ADH secretion with retention of free water; renal salt retention; renal afferent arteriolar vasoconstriction --
Affected individuals develop progressive volume overload with associated afterload reduction and increases in cardiac output (hyperdynamic circulation) --
Fluid is forced off the surface of the liver and accumulates in the abdominal cavity as ascites --
Blood is shunted around the liver through latent venous connections that become varices --
Renal function is impaired (hepatorenal syndrome) --
Volume overload may cause secondary pulmonary hypertension --
Affected individuals may also develop primary pulmonary hypertension due to anatomic alterations of pulmonary microvasculature (porto-pulmonary hypertension) --
The ability of the heart to respond to stress is impaired --
Patients develop intrapulmonary shunts that cause hypoxemia (hepatopulmonary syndrome) --
The only real remedy for these problems is orthotopic liver transplantation.
Series Title: Henry Stewart talks., Biomedical & life sciences collection., Gastroenterology and hepatology.
Responsibility: John Reinus.
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