Pulmonary Hypertension is a serious health condition that causes the arteries that carry blood from the right side of the heart to the lungs to narrow and impair blood flow. Blood must pass through the lungs to be oxygenated and distributed to the muscles, organs and other tissues of the body. However, when the arteries between the heart and lungs narrow, the amount of blood passing through the vessel will decrease, so the heart will have to make more effort to pump blood to the lungs. This condition can cause the heart to weaken over time and blood circulation in the body to deteriorate. In some individuals, this disease may worsen over time and become life-threatening. Therefore, early diagnosis and treatment is of great importance for pulmonary hypertension patients. You can read the rest of the article to learn more comprehensive answers to the questions of what is pulmonary hypertension and what is its treatment.
What is Pulmonary Hypertension?
Pulmonary hypertension, also known as pulmonary hypertension, is one of the types of high blood pressure that negatively affects the right side of the heart and lung arteries. In pulmonary hypertension, blood vessels in the lungs can become narrowed or blocked. This disease occurs as a result of high blood pressure in the arteries that carry oxygen-poor blood from the right side of the heart to the lungs. As a result, the walls of the pulmonary arteries thicken and harden. This causes the artery to fail to widen enough to allow adequate blood flow. As a result of this damage to the pulmonary vessels, blood flow slows down and blood pressure in the pulmonary arteries increases. As the vessels narrow, the heart must work harder. This can cause the heart to tire and weaken over time. A weak heart cannot fully ensure the body’s circulatory metabolism and more serious health problems such as heart failure may occur. Pulmonary hypertension is a rare disease that can affect people of all ages. However, it can be seen more frequently in individuals with other heart and lung diseases. There is more than one type of pulmonary hypertension. These can be listed as follows:
- Group 1: PH due to pulmonary arterial hypertension
- Group 2: PH due to disease on the left side of the heart
- Group 3: PH due to lung diseases
- Group 4: PH due to blockages in the lungs
- Group 5: PH due to other disorders
Pulmonary Hypertension Symptoms
Pulmonary hypertension may not cause many symptoms in the early stages, and even if symptoms are present, they are not serious. However, symptoms may worsen over time and even doing daily activities may become difficult. The early symptom of pulmonary hypertension can be seen as shortness of breath
after daily activity . Examples of these daily activities include walking, climbing stairs, or shopping. At the same time, shortness of breath may be felt during daily exercise. Symptoms of pulmonary hypertension can generally be listed as follows:
- Feeling short of breath without moving
- Skin and lip color turning purple (cyanosis)
- Chest pain and feeling of pressure in the chest
- dizziness
- Loss of appetite
- Fainting
- Fatigue and weakness
- Pain in the upper right part of the abdomen
- Edema in the abdomen, legs and ankles
- Palpitation
- Frequent shortness of breath
Pulmonary hypertension, which can be seen at any age, can be dangerous for both the mother and the baby if it develops during pregnancy. Although the symptoms of pulmonary hypertension in babies are similar to the symptoms of adults, parents need to be more careful to understand them.
Causes of Pulmonary Hypertension
Cellular changes in the tissues surrounding the pulmonary arteries can cause the artery walls to harden, thicken, or swell. These changes may cause the blood flow from the heart to the lungs to decrease and slow down, leading to the development of pulmonary hypertension. Pulmonary arterial hypertension is divided into 5 groups according to its causes. These reasons can be listed as follows:
Group 1 Pulmonary arterial hypertension (PAH) Development reasons:
- Idiopathic pulmonary arterial hypertension (IPAH): This disease, the cause of which is unknown, is characterized by the development of high blood pressure in the pulmonary arteries.
- Connective tissue diseases: Diseases that affect the structures that hold the tissues together in the body (bones, joints, tendons, cartilage, fatty tissue).
- HIV
- Diseases that develop in the liver
- Congenital heart diseases
- Sickle cell anemia: A congenital disease characterized by the defective structure of hemoglobin, which is responsible for carrying oxygen in the blood, and does not fulfill its function properly.
- Some drugs
PAH can be passed down genetically in families. In some cases, PAH disease may occur without any cause.
Group 2: Causes of PH development due to left heart diseases:
- Mitral or aortic valve diseases
- Chronic high blood pressure disease
- Left-sided heart failure
Causes of PH development due to Group 3 Lung diseases:
- Chronic obstructive pulmonary disease (COPD)
- Pulmonary fibrosis: Damage to the tissues between the air sacs in the lungs, called alveoli.
- Sleep apnea
Group 4: Causes of PH development caused by chronic blood clots:
- Chronic blood clots in the lungs
- Some other clotting disorders
Group 5: Causes of PH development due to other diseases:
- Polycythemia vera (abnormal increase in the number of cells in the blood) and thrombocythemia (abnormal increase in the number of platelets responsible for blood clotting)
- Systemic diseases such as sarcoidosis and vasculitis
- thyroid disease
- Metabolic diseases such as glycogen storage disease
- Tumors and kidney diseases that cause compression of the pulmonary arteries
Pulmonary hypertension requires treatment regardless of the cause. Treating pulmonary hypertension can prevent the progression of the disease, improve the patient’s quality of life and prevent serious complications.
How is Pulmonary Hypertension Diagnosed?
To diagnose pulmonary hypertension, the doctor first performs a general physical examination on the patient. While performing a physical examination, he examines the veins in the neck. Swollen neck veins may be a sign of heart failure. He then evaluates the size of the liver by examining the upper left area of the abdomen. He examines the abdomen and ankles to see if there is edema in those areas. Then, he takes the patient’s medical history and reviews the diseases in his family history. Pulmonary hypertension can be difficult to diagnose because the symptoms of this disease are similar to those of other heart diseases. Therefore, various tests are requested after the physical examination to make a definitive diagnosis. These tests can be listed as follows:
- X-ray: Thanks to chest X-ray, right ventricle (lower right chamber of the heart) and artery dimensions can be evaluated.
- Computed tomography (CT) : A chest CT scan may be performed to detect blood clots in the lungs that may cause pulmonary hypertension.
- Blood tests: Thanks to blood tests, the functions of organs, hormone levels and conditions such as infection can be understood.
- Doppler echocardiography: Using sound waves to check how the right ventricle is working, Doppler echo also measures blood flow through the heart valves. This way the doctor can measure systolic blood pressure.
- Right heart catheterization: This test, also known as pulmonary artery catheterization, measures the pressure in the pulmonary arteries. It can also control how much blood the heart pumps per minute.
- Polysomnography (PSG) : Polysomnography, a type of sleep test, can be applied to test whether an individual has sleep apnea.
- Pulmonary ventilation: This is another method that tests whether there is a clot in the lungs.
In addition, the doctor may also ask the patient for an exercise test. Thanks to the exercise test, it can be examined how long the patient can exercise and how much oxygen circulates in his blood during this time. In this way, it can be understood whether pulmonary hypertension is mild or severe.
Pulmonary Hypertension Treatment
To treat pulmonary hypertension, it is important to first determine the stage of the disease. Pulmonary hypertension can be classified as follows:
- Grade 1: There are no symptoms at this stage.
- Class 2: There are no symptoms at rest; However, daily activities may cause shortness of breath in the individual.
- Grade 3: It becomes more difficult to carry out daily activities. The individual feels more tired.
- Grade 4: Symptoms are present even at rest. Symptoms become more severe when doing normal activities.
After the doctor determines the stage of the disease, he prepares a treatment plan accordingly. There is currently no definitive treatment for pulmonary hypertension; However, there are treatments that can stop the progression of the disease and relieve its symptoms. Pulmonary hypertension treatment methods can be listed as follows:
- Medication: Calcium channel blockers, which are also used in traditional hypertension treatment, may be prescribed to dilate blood vessels.
- Anticoagulants: May be used to prevent blood clots from forming.
- Balloon atrial septostomy (BAS): Although this method is generally used for babies with heart defects, it can also be used in the treatment of pulmonary hypertension.
Along with these treatments, a regular diet and lifestyle changes can also make it easier to cope with the disease. An individual who says he has pulmonary hypertension can consult his doctor to get more information about this subject.
