1. Pulmonary Hypertension Affects the Lungs and the Heart
Pulmonary hypertension is elevated blood pressure in the blood vessels of the lungs. The progressive injury from the elevated pressure results in an increase in the resistance inside the vessels. This is transmitted back to the heart and in the late stages of the disease will cause failure of the right side of the heart.
2. The Causes of Pulmonary Hypertension are Complex
The causes of pulmonary hypertension are very complex. In the majority of cases, pulmonary hypertension is related to heart disease. In particular, valvular heart disease can cause a buildup of pressure in the heart that is transmitted to the lungs. If untreated, especially in the case of mitral valve disease or congenital heart disease, pulmonary hypertension can complicate treatment. If the lung pressures are seriously elevated, correcting many heart conditions can be fatal due to pulmonary hypertension. In many cases, the cause of pulmonary hypertension is unknown or idiopathic. Other causes or risk factors for pulmonary hypertension are drugs and toxins, collagen vascular disease, liver disease, chronically low oxygen levels, and chronic embolic events to the lungs (pulmonary emboli).
3. Symptoms of Pulmonary Hypertension
Patients who suffer from pulmonary hypertension complain of shortness of breath with exertion and, in advanced cases, at rest. Fatigue, chest pains and loss of consciousness can be seen as the disease progresses. Patients are weakened by the poor oxygen exchange, and may have discoloration of the lips and hands (cyanosis). The symptoms are similar to congestive heart failure as they continue to progress, swollen legs, breathlessness at rest and a distended abdomen.
4. Diagnosis of Pulmonary Hypertension
The diagnosis of pulmonary hypertension is made by specialized pulmonary function testing and right heart catheterization. The direct measurement of lung pressure can be performed by inserting a catheter into the right side of the heart under X-ray guidance. Provocative testing with medications during a catheterization can determine if a patient will benefit from certain medical treatment
5. Treatment and Prognosis of Pulmonary Hypertension
The treatment of pulmonary hypertension includes diuretics to reduce fluid accumulation, and oxygen for symptoms of breathlessness. Calcium channel blockers can be used to improve symptoms seen with exertion. Specialized inhaled and intravenous treatments, such as prostacyclin and bosentan, are available as well. The erectile dysfunction drug sildenafil (Viagria) is useful in about two-thirds of patients. Patients with severe pulmonary hypertension have a reduced life expectancy. Before the modern area of medical therapy the average life expectancy was less than two years. Currently, with excellent medical therapy many patients can expect to survive for close to 10 years.
