Pulmonary Hypertension

Causes of pulmonary hypertension

Pulmonary hypertension is high blood pressure in the arteries of the lungs, which affects the right side of your heart. Over time, it can develop into a severe condition that may restrict blood flow through the lungs. When this happens, the heart will have to work harder than normal, potentially causing your heart muscle to become weak and fail.

Proven causes of pulmonary hypertension include:

• Heart diseases such as aortic valve disease, left heart failure, mitral valve disease, congenital heart disease.
• Pulmonary hypertension can be passed down through genes. If you have a family member who has pulmonary hypertension, seek early treatment if you develop symptoms.
• Lung diseases, such as chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, obstructive sleep apnea, or long-term exposure to high altitudes.
• Chronic blood clots in the lungs or clotting disorders.
• Kidney or liver disease.
• The cause is unknown in some cases.

Risk factors for pulmonary hypertension

People of all ages, races, and ethnicities can develop pulmonary hypertension. Risk factors that increase your chances of developing it include:

• Age between 30 and 60 years old.
• Family history.
• Being overweight or obese.
• Being female.
• Taking certain weight loss medications.
• Living at high altitude.
• Abusing illegal drugs, such as cocaine.
• Having a genetic disorder such as congenital heart disease.
• Having a blood clotting disorder.

Symptoms of pulmonary hypertension

Symptoms of pulmonary hypertension progressively worsen over time. Some patients may not notice them for months or years.

Common symptoms include:

• Feeling tired or fatigued.
• Fainting or feeling lightheaded.
• Chest pain.
• Heart palpitations or a racing heart.
• Swelling.
• Shortness of breath.

It is essential to schedule an appointment with your provider to accurately diagnose your condition if you experience these symptoms. The symptoms of PH are similar to symptoms associated with other conditions such as chronic obstructive pulmonary disease.

Complications of pulmonary hypertension

The most common complication associated with pulmonary hypertension is right-sided heart failure (cor pulmonale). This may occur after the heart becomes weaker after trying to pump blood through the blocked pulmonary arteries.

Other complications include:

• Collapsed right ventricle.
• Coughing up blood (hemoptysis).
• Arrhythmias in the upper or lower chamber of the heart.
• Loss of consciousness.
• Sudden cardiac death.
• Blood clots.

Diagnosing pulmonary hypertension

Your doctor can diagnose pulmonary hypertension by analyzing your symptoms, taking a medical history, performing a physical exam, and reviewing the results of diagnostic testing.

Diagnostic and imaging tests include:

• Blood tests to determine the cause of your pulmonary hypertension or reveal any other complications.
• Chest X-ray to show if you have an enlarged right ventricle or reveal any other heart and lung conditions.
• Electrocardiogram (ECG) to detect heart rhythm abnormalities or right ventricle strain.
• Echocardiogram to determine the size of the right ventricle or measure the pressure in the pulmonary arteries.
• Right heart catheterization to confirm your pulmonary hypertension diagnosis.
• Computerized tomography (CT scan) to evaluate the size of your heart and determine if you have blood clots in the arteries to the lungs.
• Magnetic resonance imaging (MRI) to determine how well your right ventricle is working.
• Pulmonary function test (PFT) to measure how much air your lung can hold.
• Polysomnogram to measure brain activity, heart rate, blood pressure, and oxygen levels during your sleep.

Treatment for pulmonary hypertension

There is no cure for pulmonary hypertension, but your doctor will develop a treatment plan to manage your symptoms. Treatments are often highly complex and require close collaboration with your care team.

If an underlying condition is causing your pulmonary hypertension, your doctor will treat the underlying cause, if possible.

In some cases, pulmonary hypertension can be managed with lifestyle changes and medications. In more severe cases, surgery may be necessary.

When to Seek Care

The earlier pulmonary hypertension is diagnosed, the more likely treatment will be successful in stopping or slowing the disease’s progression.

If you have a family history of pulmonary hypertension or experience pulmonary hypertension symptoms, schedule an appointment with your doctor right away. If left untreated, pulmonary hypertension can worsen and potentially become fatal.