Pulmonary Hypertension – High Blood Pressure in the Heart-to-Lung System

Pulmonary hypertension (PHT) is high blood pressure in the heart-to-lung system that affects the arteries in your lungs and the right side of your heart. It is one of the comorbidities involved in Interstitial Lung Disease (ILD).

In some people, pulmonary hypertension slowly gets worse and can be life-threatening. Although there’s no cure for some types of pulmonary hypertension, treatment can help reduce symptoms and improve your quality of life.

So, how does the blood flows through your heart and lungs?

The lower right heart chamber, the right ventricle, receives oxygen-depleted blood and pumps it to your pulmonary arteries. The blood then travels to your lungs to be oxygenated, and on to the upper left heart chamber, the left atrium. From there, the oxygen-rich blood moves into the lower left chamber, the left ventricle, which pumps blood to the rest of your body through the aorta. [Source: heart.org]

[Click Here] Watch how blood flows through your heart and lungs.

Some forms of pulmonary hypertension are serious conditions that become progressively worse. Some forms of pulmonary hypertension cannot be cured, but treatments can help lessen symptoms and improve quality of life.

Symptoms of pulmonary hypertension

The signs and symptoms at initial stage may not be noticeable for months or even years. Below are some symptoms:

• Shortness of breath – initially only while exercising and eventually even while at rest/lying down
• Fatigue
• Dizziness or fainting spells (syncope)
• Chest pressure or pain
• Swelling in your ankles, legs and eventually in your abdomen (ascites)
• Bluish colour to your lips and skin
• Heart palpitations
• Decreased appetite

Causes of pulmonary hypertension

Pulmonary hypertension progresses through various means and has many origins such as:

Left heart damage – from the systolic, diastolic dysfunction of the left ventricle or due to affected heart valves of the left heart.

Respiratory system disease – diseases that affect breathing like chronic bronchitis, pneumoconiosis, nocturnal breathing stops, defects in the development of the lungs, etc.

PATE (pulmonary artery thromboembolism) – mostly arises as a consequence of the thrombophlebitis. If a thrombus that enters the pulmonary artery is small, it does not obstruct its lumen completely and does not lead to the patient’s death. But the vessels lumen narrows, which leads to increased pressure.

Toxins – continuous impact of certain chemicals from medicines leads to an increased blood pressure.

Other illness – often associated with HIV infection, sickle-cell anaemia, beta thalassemia, potent hypertension, and congenital heart defects.

Risk factors of pulmonary hypertension

• Being overweight
• Family history of the disease
• Use of illegal drugs, such as cocaine
• Certain appetite-suppressant medications

Diagnosis of pulmonary hypertension (PH)

PH develops slowly without any early signs and symptoms. When the symptoms do occur they may be attributed to asthma or other heart or lung conditions.

To diagnose the condition, your doctor may review your medical and family history and even discuss your signs and symptoms. They may ask for several tests to diagnose pulmonary hypertension. Tests may include:

• Echocardiogram
• Chest X-ray
• Electrocardiogram (ECG)
• Right heart catheterization
• Blood tests

There are some additional tests to check the condition of your lungs and pulmonary arteries and to determine the cause of your condition:

• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Pulmonary function test
• Polysomnogram
• Open-lung biopsy

Treatment of pulmonary hypertension (PH)

Pulmonary hypertension can’t be cured, but doctors can help you manage your condition. Treatment may help improve your symptoms and slow the progress of pulmonary hypertension. It can be treated by:

Medications – This depends on the symptoms you show up. Medications will help you to ease the symptoms, for example Calcium channel inhibitors, Prostanoids, etc.

Surgeries – Surgical treatment is used when drug therapy doesn’t bring any positive results. Surgical treatment includes:

• Pulmonary Thromboendarterectomy (PTE) Surgery
• Atrial septostomy
• Heart-lungs complex implantation

These lifestyle changes can improve your symptoms

• Quit smoking
• Healthy diet
• Watch your weight
• Stay active
• Get support for the anxiety and stress of living with pulmonary hypertension