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Pulmonary Hypertension

Pulmonary hypertension happens when the pressure in the blood vessels going to the lungs is too high.

The heart pumps blood from the right ventricle to the lungs to get oxygen. Because the blood does not have to travel very far, the pressure is normally low. When the pressure is too high, the arteries in the lungs narrow, and the blood does not flow as well as it should. This results in less oxygen in the blood.

There are two main kinds of pulmonary hypertension. One runs in families or appears for no known reason. The other type is related to another condition, usually heart or lung disease.

What happens once you have pulmonary hypertension?

Pulmonary hypertension may not cause any symptoms at first. Often, shortness of breath or lightheadedness during activity is the first symptom. As the disease gets worse, symptoms can include the following:

  • Tiredness.

  • Chest pain.

  • A racing heartbeat.

  • Decreased appetite.

  • Pain on the upper right side of the abdomen.

  • Shortness of breath during routine activity, such as climbing stairs.

These common symptoms often mean that people don't get diagnosed until more serious symptoms come, such as dizziness, chest pain, ankle swelling, or feeling your heart race.

What causes pulmonary hypertension?

Pulmonary hypertension can develop because of another medical condition. Breathing problems such as emphysema, chronic bronchitis and sleep apnea, are common causes. Other causes include:

  • HIV infection.

  • Liver disease/cirrhosis.

  • Congestive heart failure.

  • Birth defects in the heart.

  • Certain medicines or street drugs.

  • Blood clots in the pulmonary arteries.

  • Connective tissue diseases such as lupus or scleroderma.

  • Pulmonary fibrosis (a condition that causes scarring in the lungs).

Some people have a higher risk of pulmonary hypertension. These include people who:

  • Live at high altitudes.

  • Have a family history of the condition.

  • Use street drugs (such as methamphetamines or cocaine) or certain diet medicines.

  • Have certain conditions, such as heart disease, lung disease, liver disease, HIV infection, or blood clots in the pulmonary arteries.

Pulmonary hypertension is more common among women, people age 75 or older, and non-Hispanic African Americans.

What types of tests are used to diagnosis pulmonary hypertension?

Your doctor will probably run tests to estimate the blood pressure in your pulmonary arteries. These tests may include a chest X-ray, an echocardiogram, and a breathing test (called a lung function test). Your doctor may also need to do other tests to find out whether another medical condition is causing your pulmonary hypertension. These could include, a chest MRI, blood tests, and a chest CT scan.

If your doctor determines that you have pulmonary hypertension, he or she will want to see how severe it is. For this, they may order an exercise stress test. These tests measure your activity level and how well your lungs and heart work while you are exercising. These tests can also be done during treatment to see how well the treatment is working.

What types of treatments and procedures are used to treat pulmonary hypertension?

There is no cure for pulmonary hypertension. But treatment can improve symptoms and slow the disease. The treatment depends on the cause.

If your condition is caused by lung disease, you may need oxygen therapy to raise the level of oxygen in your blood. Or if blood clots cause it in your lungs, you will need to take blood-thinning medicines to prevent clots from getting larger.

Treatments include:

  • Diuretics (water pills): These reduce fluid build-up in your body.

  • Blood-thinners: These help prevent blood clots from forming or getting bigger.

  • Oxygen therapy: This raises the level of oxygen in your blood.

  • Other medicines: Medicine that relaxes the blood vessels allows more blood to flow.

In some severe cases, people who have pulmonary hypertension need surgery. This could include a lung transplant or a heart and lung transplant.

What can I do to support my health when I have pulmonary hypertension?

You can take steps to slow the progress of pulmonary hypertension by making healthy lifestyle changes and managing high blood pressure, coronary heart disease, chronic liver disease, and chronic lung disease from tobacco use.

In addition to seeking treatment, there are steps you can take to prioritize your physical health by relaxing, energizing, strengthening, and nourishing your body. Here are a few places to begin:

  • Reduce salt in your diet.

  • Maintain a healthy body weight.

  • Never smoke, or stop smoking.

  • Drink only moderate amounts of alcohol, if any. This means an average of one to two drinks per day for men and one drink per day for women.

  • Eat a healthy, well-balanced diet, rich in fresh fruit and vegetables but low in saturated fats, processed sugar, and salt.

  • If you have diabetes, work closely with your doctor to make sure it is controlled.

  • Get at least 150 minutes of moderate to intense physical exercise every week.

Why choose Presbyterian for pulmonary hypertension treatment?

Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.