Pulmonary Hypertension

What is Pulmonary Hypertension?

Well the words themselves describe it:

  • Pulmonary = Lung
  • Hypertension = High Blood Pressure

Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. PH is a serious illness, and 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.

In one form of pulmonary hypertension, called pulmonary arterial hypertension (PAH), blood vessels in your lungs are narrowed, blocked, or destroyed. The damage slows blood flow through your lungs, and blood pressure in the lung arteries rises. The right ventricle of your heart must work harder to pump blood through your lungs. The extra effort eventually causes the muscle of the right ventricle to become weak and fail.

The signs and symptoms of pulmonary hypertension develop slowly. You may not notice them for months or even years. Symptoms get worse as the disease progresses.

Pulmonary hypertension symptoms include:

  • Shortness of breath (dyspnea), initially while exercising and eventually while at rest
  • Fatigue
  • Dizziness or fainting spells (syncope)
  • Chest pressure or pain
  • Swelling (edema) in your ankles, legs, and eventually in your abdomen (ascites)
  • Bluish color to your lips and skin (cyanosis)
  • Racing pulse or heart palpitations

Growing older can increase your risk of developing pulmonary hypertension. The condition is more often diagnosed in people ages 30 to 60. However, idiopathic PAH is more common in younger adults.

Other things that can raise your risk of pulmonary hypertension include:

  • A family history of the condition
  • Being overweight
  • Blood-clotting disorders or a family history of blood clots in the lungs
  • Exposure to asbestos
  • Genetic disorders, including congenital heart disease
  • Living at a high altitude
  • The use of appetite-suppressant medications for weight loss (for example, fenfluramine, dexfenfluramine, phentermine or abuse of recreational drugs (for example, cocaine, methamphetamine, and amphetamine)
  • The presence of other medical conditions, including lung disease (for example, emphysema), heart disease (for example, heart failure), and general medical conditions (for example, connective tissue disease like scleroderma).

Complications of pulmonary hypertension include:

  • Right-sided heart enlargement and heart failure (cor pulmonale). In cor pulmonale, your heart's right ventricle becomes enlarged and has to pump harder than usual to move blood through narrowed or blocked pulmonary arteries.
  • At first, the heart tries to compensate by thickening its walls and expanding the chamber of the right ventricle to increase the amount of blood it can hold. But these changes create more strain on the heart, and eventually, the right ventricle fails.
  • Blood clots. Having pulmonary hypertension makes it more likely you'll develop clots in the small arteries in your lungs, which is dangerous if you already have narrowed or blocked blood vessels.
  • Arrhythmia. Pulmonary hypertension can cause irregular heartbeats (arrhythmias), which can lead to a pounding heartbeat (palpitations), dizziness, or fainting. Certain arrhythmias can be life-threatening.
  • Bleeding in the lungs. Pulmonary hypertension can lead to life-threatening bleeding into the lungs and coughing up blood (hemoptysis).
  • Pregnancy complications. Pulmonary hypertension can be life-threatening for a woman and her developing baby.

Many medications can treat PH, helping to alleviate the symptoms of PH, improving patients' wellbeing, activity, and quality of life. Medical treatment can also slow the progression of PH and improve RV failure, and often improve survival.