Pulmonary Hypertension

Overview

What is pulmonary hypertension?

"Pulmonary" means "in the lungs," and"hypertension" means "high blood pressure." Pulmonaryhypertension is an increase in blood pressure in the blood vessels that carryblood to the lungs. It is a serious health problem.

Pulmonary arteries are the blood vessels that carry bloodfrom your heart to your lungs. If these arteries narrow or become blocked ordamaged, they cannot carry as much blood. This puts strain on your heartbecause it has to work harder to push blood through your lungs. Pressure buildsup in the narrowed arteries. This results in high blood pressure in the rightside of your heart and in the blood vessels that carry blood to the lungs.

Symptoms

What are the symptoms of pulmonary hypertension?

Pulmonary hypertension may not cause any symptoms at first. As the disease gets worse, symptoms can include the following:

Symptoms of pulmonary hypertension usually limit a person’s ability to exercise and do other activities.

  • Shortness of breath, with or without activity

  • Cough

  • Fatigue

  • Dizziness

  • Chest pain or pressure

  • Rapid heartbeat

  • Swelling of the ankles, legs and abdomen

Causes & Risk Factors

What causes pulmonary hypertension?

Many things can cause pulmonary hypertension. However, sometimes the cause isn’t known. When the cause of pulmonary hypertension isn’t known, it is called idiopathic pulmonary hypertension (IPH).

When pulmonary hypertension develops because of another medical condition, it is called secondary pulmonary hypertension. Breathing problems such as emphysema and chronic bronchitis, as well as sleep apnea, are common causes of secondary pulmonary hypertension. Other causes include the following:

  • Congestive heart failure

  • Birth defects in the heart

  • Chronic pulmonary thromboembolism (blood clots in the pulmonary arteries)

  • Acquired immunodeficiency syndrome (AIDS)

  • Cirrhosis (a chronic liver disease)

  • Lupus

  • Pulmonary fibrosis (a condition that causes scarring in the lungs)

  • Certain medicines

Diagnosis & Tests

How does my doctor know that I have pulmonary hypertension?

Signs of pulmonary hypertension can be similar to the signs of many other health problems. This makes it hard to diagnose. Your doctor will probably run some tests to estimate the blood pressure in your pulmonary arteries and find out how well your heart and lungs are working. These tests may include a chest X-ray, a breathing test called a pulmonary function test and an echocardiogram (sometimes called an "echo"). Your doctor may also need to do other tests to find out whether another medical condition is causing your pulmonary hypertension.

Treatment

How is pulmonary hypertension treated?

If the cause of your pulmonary hypertension is known,treating the cause may improve your condition. Lifestyle changes can also helpyou feel better. If you smoke, stop. Maintain a healthy weight, eat anutritious diet and reduce the amount of stress in your life. If you are a loudsnorer or have other signs of sleep apnea, ask your doctor about a sleep studyto diagnose this condition. Ask your doctor to recommend ways that you can stayas active as possible.

Breathing oxygen from a tank can help relieve shortness ofbreath. Medicines that can be used to treat pulmonary hypertension include thefollowing:

Your doctor will decide what type of medicine is right foryou.

In some cases, people who have pulmonary hypertension needsurgical treatment. Surgical treatment options include a lung transplant and atype of heart surgery called atrial septostomy (say: "ay-tree-allsep-toss-teh-mee").

  • Endothelin receptor antagonists

  • Phosphodiesterase-5 inhibitors

  • Prostacyclins

  • Anticoagulants (blood-thinning medicine)

  • Calcium channel blockers

  • Diuretics (water pills)

  • Digoxin

Other Organizations

Questions to Ask Your Doctor

  • How do you know what’s causing my pulmonary hypertension?

  • Is the underlying condition treatable?

  • What kind of tests will I need? Are they covered by insurance?

  • Is it safe for me to exercise? What kinds of exercise can I do?

  • I have other health problems. Will treatment of pulmonary hypertension affect the treatment of my other health problems?

  • Will I need surgery? What does surgery entail?

Citations

  • Diagnosis and Treatment of Pulmonary Hypertension by TD Nauser, MD; SW Stites, MD( 05/01/01, http://www.aafp.org/afp/20010501/1789.html)