Pulmonary Hypertension

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Pulmonary Hypertension

Pulmonary Hypertension is a type of high blood pressure that affects your arteries in the lungs as well as the right side of the heart. This condition is life-threatening and it generally gets worse over time. However, treatments can help you to lessen your symptoms so that you can live better with the disease. Although it may take some time, patients are generally able to live life normally, the way they did before their diagnosis.

In this condition, the tiny arteries in your lungs get narrow or blocked, which makes it harder for the blood to flow through them, which causes the blood pressure in your lungs to rise. This makes your heart work harder to pump blood through those arteries, and after a while the muscle of the heart gets weak. Eventually, it leads to heart failure.

Symptoms

The signs and symptoms of pulmonary hypertension develop slowly, and it takes take months or sometimes even years, for you to notice them. As the disease progresses, the symptoms get worse.

The symptoms of pulmonary hypertension include:

  • Fatigue
  • Chest pressure or pain
  • Dizziness or fainting spells
  • Swelling in your ankles and legs, and eventually in the abdomen
  • Racing pulse or heart palpitations
  • Bluish color to your lips and skin

Causes & risk factors

Sometimes your doctors are unable to find the reason for your high blood pressure in your lungs. In such cases, the condition is termed idiopathic pulmonary hypertension. Genes might play a role in why some people get this illness.

Sometimes, another condition can also lead to pulmonary hypertension, which can include any of these:

  • Congestive heart failure
  • Liver disease
  • Lupus, scleroderma, rheumatoid arthritis, and other autoimmune diseases
  • Blood clots in the lungs
  • HIV
  • Lung diseases like emphysema, chronic bronchitis, or pulmonary fibrosis
  • Sleep apnea
  • Illegal drug use
  • A heart defect you’re born with

 

Having a family history of pulmonary hypertension, being obese or overweight, exposure to asbestos, taking illegal drugs such as cocaine, living at a high altitude, are some of the factors that can increase your risk of developing pulmonary hypertension.

Diagnosis

It is generally hard to diagnose this condition early as it is often not detected during a routine physical exam. Even when the condition is more advanced, this condition shows signs and symptoms that are similar to those of other heart and lung conditions.

Your doctor is first going to perform a physical exam and then talk to you regarding your signs and symptoms. You will be asked questions regarding your medical and family history.

Some of the tests that your doctor can order might include any of the following:

Blood tests

A blood test helps your doctor to determine the cause of pulmonary hypertension as well as to look for signs of complications.

Chest X-ray

A chest X-ray is able to create pictures of your lungs, chest, and your heart. It is also able to show an enlargement of the right ventricle of the heart or the pulmonary arteries, which might occur in pulmonary hypertension. A chest X-ray can also be used to check for other lung conditions which can lead to pulmonary hypertension.

Electrocardiogram (ECG)

This is a noninvasive test that can show electrical patterns of your heart and can detect any abnormal heartbeats as well. It might reveal signs of right ventricle enlargement as well as strain.

Echocardiogram

Sound waves can help to create moving images of your beating heart. An echocardiogram is able to let your doctor see how well your heart and its valves are functioning. Your doctor may also use it to determine the size and thickness of your right ventricle or to measure the pressure in your pulmonary arteries. Sometimes, an echocardiogram is done as you exercise on a stationary bike or treadmill to understand how well your heart can work while you are performing any activity. You may be asked to wear a mask as well, which can check how well your heart and lungs use oxygen and carbon dioxide. An echocardiogram is sometimes done after diagnosis as well so that your doctor is able to assess how effectively your treatments are working.

Right heart catheterization

If your echocardiogram reveals pulmonary hypertension, you are likely going to need a right heart catheterization in order to confirm the diagnosis. During this test, a cardiologist is going to place a thin, flexible tube or catheter into a vein in your neck or groin. This catheter is next threaded into the right ventricle and pulmonary artery. Right heart catheterization can also help your doctor to measure the pressure in the main pulmonary arteries and right ventricle of the heart directly. It can also help him/her understand what kind of effects different medications might have on your pulmonary hypertension. Your doctor can also order a few more tests which can include a CT scan, an MRI, a pulmonary function test, a polysomnogram, or an open lung biopsy.

Treatment

Pulmonary hypertension differs from person to person, and this is why your treatment plan will need to be specific to your needs. Generally, first, the doctor treats the cause of your condition. For example, if your problem is caused by another condition such as emphysema, then he/she will focus on treating it, to improve your pulmonary hypertension.

Many people also receive oxygen therapy, which is a form of treatment to improve their breathing. It can be extremely beneficial if you are short of breath, or if you have low oxygen levels in your blood. It can also help you live longer if you are having pulmonary hypertension. If you are at risk for blood clots, then your doctor might also recommend blood thinners.

Atrial septostomy

If medications don’t help your condition, then this open-heart surgery can be an option. This procedure involves your surgeon creating an opening between the upper left and right chambers of your heart, to relieve the pressure on the right side of your heart. It is to be noted, however, that this treatment may lead to serious complications, such as arrhythmia, heart rhythm problems.

Lung Transplant

In some cases, a lung or heart-lung transplant can be an option, especially for younger people who have idiopathic pulmonary arterial hypertension.

There are certain major risks to organ transplantation. This includes rejection of the transplanted organ, as well as a serious infection. You might also need to take immunosuppressant drugs for life in order to reduce the chances of rejection.

Complications

Some of the complications that this condition can lead to include:

  • Right-sided heart enlargement and heart failure
  • Arrhythmia
  • Bleeding in the lungs
  • Complications during pregnancy

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