Pulmonary Hypertension

Pulmonary Hypertension

Pulmonary hypertension occurs when the pressure in blood arteries leading from the heart to the lungs rises, affecting the right side of the heart.

Pulmonary arterial hypertension (PAH), a kind of pulmonary hypertension, causes blood vessels in the lungs to be narrowed, blocked or destroyed, slowing the blood flow through the lungs while increasing the blood pressure in the lung.

The heart works harder to pump blood through the lungs. This extra force ultimately causes the heart muscle to be weak and fail and, in some cases, be life-threatening.

While there's no cure for a few types of pulmonary hypertension, treatment often helps lessen its symptoms and improve the quality of life.

Understand the symptoms

Pulmonary hypertension symptoms may develop gradually, and its signs being visible only months or even years later. However, the indications worsen as the disease progresses, with symptoms causing fatigue, dizziness or fainting spells (syncope) and shortness of breath (dyspnea) that starts while exercising and ultimately even during rest.

The other signs are chest pressure or pain, swelling (edema) in the ankles, legs and eventually in your abdomen (ascites), racing pulse or heart palpitations and bluish color to the lips and skin (cyanosis).

Know the causes

The heart has two chambers upper - atria and lower - ventricles. When the blood passes through the heart each time, the lower right chamber (right ventricle) taps blood to the lungs via a large blood vessel (pulmonary artery).

Any changes in the cells that line the pulmonary arteries leading to the arteries' walls becoming stiff, swollen and thick. These alterations slow down or block blood flow through the lungs, causing pulmonary hypertension, which is classified into five groups:

Group 1: Pulmonary arterial hypertension (PAH)

The causes include unknown reasons - idiopathic pulmonary arterial hypertension, a genetic mutation passed down through families - heritable pulmonary arterial hypertension, use of some prescription diet drugs or illegal drugs like methamphetamines — and other drugs. Heart problems like congenital heart disease and other ailments like connective tissue disorders (scleroderma, lupus, others), HIV infection or chronic liver disease (cirrhosis) are the different reasons.

Group 2: Pulmonary hypertension due to left-sided heart disease

The causes for this condition include left-sided heart valve diseases, like mitral valve or aortic valve disease and failure of the lower left heart chamber (left ventricle).

Group 3: Pulmonary hypertension cause of lung disease

The causes for this condition include chronic obstructive pulmonary disease (COPD), obstructive sleep apnea, pulmonary fibrosis causing scarring in the tissue between the lungs' air sacs (interstitium). Also, long-term exposure to high altitudes in people who may be at higher risk of pulmonary hypertension.

Group 4: Pulmonary hypertension caused by chronic blood clots

The causes for this condition are chronic blood clots in the lungs (pulmonary emboli) and other clotting disorders.

Group 5: Pulmonary hypertension influenced by other health conditions

The causes for this condition are blood disorders, essential thrombocythemia and kidney disease. Also, inflammatory disorders - sarcoidosis, vasculitis, and metabolic disorders, including glycogen storage disease raise the risk.

Recognise the risk

People ages 30 to 60 are more prone to developing pulmonary hypertension, and idiopathic PAH is more likely in younger adults.

Other factors that raise the risk of pulmonary hypertension are overweight, a family history of the condition, asbestos exposure, blood-clotting disorders or a family history of blood clots in the lungs.

The other reasons are genetic disorders, including congenital heart disease, living at a high altitude, use of certain weight-loss drugs, illegal drugs such as cocaine and selective serotonin reuptake inhibitors (SSRIs), used to treat depression and anxiety.

Associated complexities

The complications from pulmonary hypertension are:
• Right-sided heart enlargement and heart failure.
• Blood clots.
• Bleeding in the lungs and pregnancy complications.

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