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Pulmonary hypertension is abnormally high blood pressure in the arteries of the lungs. It makes the right side of the heart need to work harder than normal.
Alternative NamesPulmonary arterial hypertension; Sporadic primary pulmonary hypertension; Familial primary pulmonary hypertension; Idiopathic pulmonary arterial hypertension; Primary pulmonary hypertension; PPH; Secondary pulmonary hypertension
Causes, incidence, and risk factorsThe right side of the heart pumps blood through the lungs, where it can receive oxygen.
When the small arteries (blood vessels) of the lung become narrowed, they cannot carry as much blood. When this happens, pressure builds up. This is called pulmonary hypertension.
The heart needs to work harder to force the blood through the vessels against this pressure. Over time, the right side of the heart may become enlarged. At some point, not enough blood flows to the lungs to pick up oxygen and symptoms begin.
At this point, heart failure that involves the right side of the heart is present. This is called cor pulmonale.
Pumonary hypertension may be caused by:
- Any condition that causes chronic low oxygen levels in the blood
- Autoimmune diseases that damage the lungs, such as scleroderma and rheumatoid Arthritis
- Certain birth defects of the heart
- Certain diet medications
- Congestive heart failure
- History of a blood clot in the lung
- HIV infection
- Lung or heart valve disease
- Obstructive sleep apnea
In many cases the cause is unknown, in which case the condition is known as idiopathic pulmonary arterial hypertension (IPAH). IPAH is rare. It affects more women than men.
If it is caused by a known medicine or medical condition, it is called secondary pulmonary hypertension.
SymptomsShortness of breath or light-headedness during activity is often the first symptom.
- Fast heart rate (palpitations) may be present
- Over time, symptoms occur with lighter activity or even while at rest
Other symptoms include:
- Ankle and leg swelling
- Bluish color of the lips or skin (cyanosis)
- Chest pain or pressure, usually in the front of the chest
- Dizziness or faintingspells
- Fatigue
- Weakness
People with pulmonary hypertension report good days and bad days.
Signs and testsA physical examination may show:
- Abnormal heart sounds (especially a splitting of the second heart sound)
- Enlargement of the veins in the neck
- Feeling of a pulse over the breastbone
- Heart murmur
- Leg swelling
- Liver and spleen swelling
- Normal breathing sounds
In the early stages of the disease, the exam may be normal or almost normal. The condition may take several months to diagnose. Asthma causes similar symptoms and must be ruled out.
Tests may include:
- Cardiac catheterization
- Chest x-ray
- CT scan of the chest
- Echocardiogram
- ECG
- Nuclear lung scan
- Pulmonary arteriogram
- Pulmonary function tests
- Sleep study
There is no known cure. The goal of treatment is to control symptoms. It is important to treat medical disorders that cause pulmonary hypertension, such as obstructive sleep apnea, lung conditions, and heart valve disorders.
Many new treatment options for idiopathic pulmonary arterial hypertension (IPAH) and other forms of pulmonary aterial hypertension are becoming available. Medicines used to treat pulmonary hypertension include:
- Ambrisentan (Letairis)
- Bosentan (Tracleer)
- Calcium channel blockers
- Diuretics
- Prostacyclin or similar medications
- Sildenafil
Your doctor will decide which medicine is best for you. You will be closely monitored during treatment to watch for side effects and to see how well you're responding to the medication. Never stop taking medicines without talking to your doctor.
Some patients are put on blood thinners to reduce the risk of blood clots in leg veins and lung arteries.
People with advanced cases of pulmonary arterial hypertension may need oxygen. If treatment with medications fails, suitable candidates may be helped by a lung or heart-lung transplant.
As the illness progresses, you will need to make changes in the home environment and get more help around the home.
Other important tips to follow:
- Avoid pregnancy
- Avoid strenuous activities and heavy lifting
- Avoid traveling to high altitudes
- Keep up to date with yearly flu and pneumococcal pneumonia vaccines
- Stop smoking
The long-term outlook has been poor, but new therapies may produce better results. Some people with this condition may develop progressive heart failure that may lead to death.
Avoiding pregnancy is recommended.
Calling your health care providerCall your health care provider if:
- You begin to develop shortness of breath when you are active
- Shortness of breath worsens
- You develop chest pain
- You develop other symptoms
Most patients with pulmonary arterial hypertension are treated at centers that specialize in the care of these patients.
ReferencesBadesch DB, Abman SH, Simonneau G, et al. Medical Therapy for Pulmonary Arterial Hypertension Updated ACCP Evidence-Based Clinical Practice Guidelines. Chest. 2007: 131(6).
McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, et al: American College of Cardiology Foundation Task Force on Expert Consensus Documents; American Heart Association; American College of Chest Physicians; American Thoracic Society, Inc; Pulmonary Hypertension Association. ACCF/AHA 2009 expert consensus document on pulmonary hypertension: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians: American Thoracic Society, Inc; and the Pulmonary Hypertension Association. J Am Coll Cardiol. 2009;53:1573-1619.
What else can I help you with?
What is anaemia emphysema and hypertension?
cor pulmonary
Where can I find info on pulmonary hypertension?
You can find all the information you need to know about the disease, pulmonary hypertension, at this website, http://en.wikipedia.org/wiki/Pulmonary_hypertension.
Are hypertension and pulmonary hypertension the same?
Postural means standing. Hypertension means high blood pressure and hypotension is low blood pressure. You get a different reading if you are sitting versus standing while taking blood pressure.
What color represents Primary Pulmonary Hypertension?
periwinkle
What is pulmonary?
Pulmonary is a term that is relating to the lungs. When someone has a high blood pressure in the arteries of the lungs, they would have pulmonary hypertension.
Can cirrhosis cause pulmonary hypertension?
Yes, cirrhosis can lead to pulmonary hypertension, primarily through the development of portopulmonary hypertension. This condition arises when increased blood flow and pressure in the pulmonary arteries occur due to changes in the vascular system associated with liver disease. Additionally, cirrhosis can cause hypoxia and other factors that may further contribute to elevated pulmonary artery pressure. It is important for patients with cirrhosis to be monitored for potential cardiovascular complications, including pulmonary hypertension.
What is The correct ICD-10 code for essential hypertension?
The code for hypertension is I10
How does obstructive sleep apnea contribute to the development of pulmonary hypertension?
Obstructive sleep apnea can lead to pulmonary hypertension by causing repeated episodes of low oxygen levels during sleep. This can put strain on the heart and lungs, leading to increased blood pressure in the lungs and potentially causing pulmonary hypertension.
Can MS cause pulmonary hypertension?
if it gets to bad yes
What are the reasons for pulmonary hypertension?
The cause of pulmonary hypertension is unknown. It is rare, affecting one people per-million. The illness most often occurs in young adults, especially women.
where can I get info on pulmonary hypertension.?
There are five different types of pulmonary hypertension including artery, venous, hypoxic, thromboembolic and miscellaneous. This disease can cause heart failure so it is very serious.
Is there a connection to cardio-artery disease and pulmonary hypertension?
Pulmonary hypertension(P-h) is a syndrome that involves heart and lung. Diseases like COPD (chronic pulmonary disease) May also cause pulmonary hypertension. Not all the cardio-artery disease is related to P-h. Heart has valves. Dysfunction of these valves will cause tension to the blood flow, leading to p-h.
