Pulmonary hypertension (PH)

Pulmonary hypertension (PH)

Overview

Pulmonary hypertension (PH) is a type of coronary artery disease (CAD). This condition occurs when pressure in the pulmonary arteries becomes abnormally elevated. There is inflammation in the lining of the pulmonary artery, which changes the cells in the lining. Consequently, it becomes more difficult for the heart to pump blood forward into the lungs to be oxygenated.

PH usually develops between the ages of 20 and 60.

 

Causes

Constriction, or stiffening, of the pulmonary arteries that supply blood to the lungs causes pulmonary hypertension. There are five categories of PH, determined by the pressure in the pulmonary arteries while the person is at rest and during activity. Often, other heart and lung diseases or blood clots cause pulmonary hypertension. The disease is sometimes hereditary.

Symptoms

Symptoms of PH range in severity and can include shortness of breath with everyday activities, fatigue, chest pain, racing heartbeat, dizziness and fainting spells. If the heart becomes too weak to pump a sufficient amount of blood to the lungs, it may cause heart failure.

Risk factors

  • Having heart, lung or liver disease, HIV infection or blood clots in the pulmonary arteries
  • Family history of pulmonary hypertension
  • Use of street drugs
  • Use of certain diet pills
  • Living at high altitude

Diagnosis

Besides a physical exam and taking your family history, a physician may diagnose PH with the following means:

  • Echocardiography
  • Chest X-ray
  • Electrocardiogram
  • Right heart catheterization
  • Chest CT scan
  • Chest MRI
  • Lung function tests
  • Polysomnogram (PSG)
  • Lung ventilation/perfusion (VQ) scan
  • Blood tests

To determine the severity of the disease, your doctor also may use exercise testing.

Treatment

While there is no cure for PH, it can be managed with medications and certain therapies:

  • Diuretics
  • Blood-thinning medicines
  • Digoxin
  • Oxygen therapy

Lifestyle changes such as increasing physical activity (under guidance) also are an important factor in slowing the progression of the disease and lessening its symptoms.  

For more severe disease, surgery may be indicated.

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