Pulmonary Hypertension

Pulmonary hypertension is high blood pressure in the blood vessels that supply the lungs (pulmonary arteries).

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What is pulmonary hypertension?

Pulmonary hypertension is a condition that refers to increased blood pressure in the blood vessels in the lungs due to narrowing and/or blockage. It’s a very serious condition as it disrupts the flow of blood through your heart and lungs. This puts strain on these organs and can lead to heart failure if left untreated.

Pulmonary hypertension is a rare condition but is more common in people who have another heart or lung condition. Although rare, the condition can affect people of all ages, so it’s important to be aware of the symptoms for early diagnosis and successful treatment.

What causes pulmonary hypertension?

Pulmonary hypertension comes as a result of changes in the cells that line pulmonary arteries, which causes the walls of the arteries to become stiff, swollen and thick. There are a number of causes for this including:

  • Connective tissue diseases, such as scleroderma or lupus
  • Chronic blood clots in the lungs
  • Liver cirrhosis
  • Congenital heart disease
  • Chronic respiratory conditions such as chronic obstructive pulmonary disease (COPD) and interstitial lung disease
  • Cardiac conditions that affect the left side of the heart such as mitral valve or aortic valve disease and heart failure
  • Hereditary changes in genes
  • Conditions such as kidney disease, blood disorders, inflammatory disorders and metabolic disorders
  • Use of certain drugs or illegal substances
  • In many cases, no cause is found, and this is termed idiopathic

What are the symptoms of pulmonary hypertension?

Some people will have no symptoms in the initial stages of pulmonary hypertension. However, it’s common for the first symptom to be shortness of breath.

Other symptoms include:

  • Chest pain or tightness
  • Dizziness and/or fainting
  • Heart palpitations
  • Excessive fatigue
  • Reduced appetite
  • Pain in the upper right side of your abdomen
  • Swelling (oedema) in your ankles, legs or abdomen

Symptoms tend to start out mild and worsen as the condition progresses. It’s important to see a respiratory specialist as soon as you notice any of these symptoms so that you can start treatment quickly.

The symptoms of pulmonary hypertension are similar to those of many other heart and lung conditions, so a number of tests are required to make a correct diagnosis, determine the cause and define treatment. These may include blood tests, lung function and exercise testing, a chest x-ray, an electrocardiogram (ECG), an echocardiogram, cardiac MRI, CT scan, ventilation-perfusion scan, ultrasound of the liver and cardiac catheterisation.

What are the treatment options for pulmonary hypertension?

Pulmonary hypertension cannot be cured, but there are treatments that help to reduce symptoms and slow the progression of the condition.

If the condition is caused by an underlying medical problem, this will be addressed first. Other treatments include medications such as anticoagulants (blood thinners), vasodilators (blood vessel dilators) and diuretics (water pills), oxygen therapy, surgery and dietary and lifestyle changes.

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