Pulmonary Hypertension and Treatment

Pulmonary Hypertension and Treatment
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Pulmonary hypertension and its treatment is something all patients should familiarize themselves with. Fully understanding this condition is essential to best manage it. Between the years 1980 and 2002, the incidence of this condition causing death rose from 10,992 to 15,668, according to the Centers for Disease Control and Prevention. However, this condition is considered rare in the United States.

What is Pulmonary Hypertension?

This condition is characterized by the blood pressure in the lungs’ arteries being abnormally high. This condition results in the heart’s right side having to work harder than it normally should. This condition can be caused by a number of things, such as:

  • Conditions causing chronic low blood-oxygen levels
  • Certain birth defects affecting the heart
  • Congestive heart failure
  • HIV infection
  • Obstructive sleep apnea
  • Autoimmune diseases causing lung damage, such as rheumatoid arthritis and scleroderma
  • Certain diet medications
  • Having a history of pulmonary blood clots
  • Heart valve or lung disease
  • In many cases, it is unknown what causes this condition

Symptoms of this Condition

The first symptoms often include being lightheaded or experiencing shortness of breath during activity. Another early symptom includes:

Other possible symptoms include:

  • Leg and ankle swelling
  • Pressure or pain in the chest
  • Fatigue
  • Cyanosis of the lips
  • Fainting spells or dizziness
  • Weakness

Diagnosing this Condition

When diagnosing this condition, a physical exam is performed first. When this condition is present, the following findings are often present:

  • Abnormal heart sounds
  • Feeling a pulse across the breastbone
  • Leg swelling
  • Normal breathing sounds
  • Neck vein enlargement
  • Heart murmur
  • Spleen and liver swelling

Diagnostic testing can include:

  • Cardiac catheterization
  • Chest CT scan
  • ECG
  • Pulmonary arteriogram
  • Sleep study
  • Chest x-ray
  • Echocardiogram
  • Nuclear lung scan
  • Pulmonary function tests

Goal of Treatment

There is no cure for this condition, but there are treatments to help control the symptoms. The underlying condition must be treated in order to have the best results.

Drug Treatments

There are several medications that can be used to control the symptoms of this condition. The medications used for pulmonary hypertension and treatment include:

  • Ambrisentan is a vasodilator that helps to lower pulmonary blood pressure
  • Calcium channel blockers can help with high blood pressure
  • Prostacyclin or similar medications
  • Bosentan assists in blocking the substance responsible for narrowing the blood vessels in the lung, endothelin
  • Diuretics help to flush out any fluid that has accumulated in the bloodstream or tissues
  • Sildenafil helps to dilate the pulmonary arteries by relaxing the pulmonary smooth muscle cells
  • Blood thinners help to prevent blood clots

Surgical Therapies

When this condition is advanced, oxygen can be used. If all treatments fail, a lung or combination lung-heart transplant may be necessary. This is a very rare surgical procedure, but patients who experience both left heart failure and lung failure may have to have this procedure.

A lung transplant is the only thing that can cure this condition. However, only those who have not responded to other treatments are candidates. Approximately 1,000 people in the United States each year have a lung transplant.

A pulmonary thromboendartectomy is a surgical procedure performed when a patient needs to have a large pulmonary artery blood clot removed. This can help to improve lung function and blood flow.

Other Treatments

Other ways to help control this condition, include:

  • Avoid pregnancy
  • Avoid high altitudes
  • Ensure all pneumococcal and flu vaccines are up to date
  • Avoid heavy lifting and strenuous activity
  • Quit smoking

Resources

MedlinePlus. (2010). Pulmonary Hypertension. Retrieved on August 25, 2010 from MedlinePlus: https://www.nlm.nih.gov/medlineplus/ency/article/000112.htm

MayoClinic.com. (2010). Pulmonary Hypertension. Retrieved on August 25, 2010 from MayoClinic.com: https://www.mayoclinic.com/health/pulmonary-hypertension/DS00430

Hyduk, A. et al. (2005). Pulmonary Hypertension Surveillance – United States, 1980 – 2002. Retrieved on August 25, 2010 from the Centers for Disease Control and Prevention: https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5405a1.htm