Pulmonary hypertension: Symptoms, Causes and Treatments
What is Pulmonary hypertension?
Pulmonary hypertension affects arteries in the lungs and the right side of the heart with high blood pressure. One of its forms is Pulmonary arterial hypertension(PAH). In PAH, blood vessels in your lungs narrow, clog, or are destroyed. As a result, the blood flow through the lungs gets slow due to the caused damage. Thus, the blood pressure in the lung arteries rises, making it hard for the heart to pump blood through the lungs. So, the heart's extra effort in such a situation causes the heart muscle to weaken and fail.
In some people, PH gradually gets worse and can be life-threatening at a time. This condition has no cure, but available treatments may help improve your quality of life. It may minimize the risks and help you feel better and live longer.
Symptoms of Pulmonary Hypertension:
It is a progressive disease, and symptoms of Pulmonary hypertension may develop slowly. It may take months or even years to show you noticeable symptoms. In certain situations, these symptoms may flare up as:
- Chest pain or pressure
- At first ma, shortness of breath may appear while exercising and eventually at rest.
- Low oxygen levels cause your skin colour to be blue or grey skin. Due to different skin colour, these changes can be complex to notice in some people.
- Fatigue
- Dizziness or fainting
- Swelling in the ankles, legs and belly area
- Fast pulse or pounding heartbeat
One of the most common symptoms that people experience in PH is shortness of breath. But this symptom can also appear due to conditions like asthma. So, it would be best to discuss this with a healthcare professional to have an accurate diagnosis.
Causes of Pulmonary Hypertension:
A typical human head has 4 chambers, two in the upper and two in the lower. Every time the blood moves through the heart, the lower right chamber keeps pumping the blood to the lungs. It passes through a large blood vessel known as the pulmonary artery.
But, when there is a change in the cells of the lung arteries, specific changes may appear. It may cause the artery walls to become narrow, stiff, swollen and thick, which might cause constriction of these arteries. Thus, these changes may slow down or stop the blood flow through the lungs. It may lead to conditions like Pulmonary hypertension. Depending on the causes, there are five types of Pulmonary hypertension. We have listed them below here.
Different Types of Pulmonary Hypertension:
Based on the causes, the World Health Organization (WHO) has divided Pulmonary hypertension into five groups.
Group 1:PH due to pulmonary arterial hypertension (PAH):
PAH may have many different causes, including underlying diseases and the use of certain drugs. Under this condition, the pulmonary arteries become narrow, stiff, swollen and thick. It may result in less blood flow and raised pressure in pulmonary arteries.
Group 2: PH due to left-sided heart disease:
It is among the most common forms of pulmonary hypertension that appears in people. The causes of this condition include failure of the left heart and left-side heart valves. It happens when there is a problem on this side of your heart; it affects the right side of the heart and the entire pulmonary circuit. As a result, blood backs up in the heart, and the pressure rises in the pulmonary arteries.
Group 3: PH due to lung disease:
Due to certain lung diseases, arteries in your lungs can get tightened. Thus, it may lead to less blood flow through your lungs and a rise in the pressure in your pulmonary arteries. One may suspect scarring of the lungs, known as pulmonary fibrosis, sleep apnea, or chronic obstructive pulmonary disease.
Group 4: PH due to blockages in your lungs:
Blockage in your lungs due to blood clots or scars prevents blood from flowing normally through the lungs. It may put the right side of the heart under more stress and raise pulmonary blood pressure. Also, tumours may block the pulmonary arteries in this condition.
Group 5: PH due to other disorders:
PH, along with other health conditions like metabolic disorders and blood disorders. The reason behind the triggering of PH under this condition is not exactly apparent.
Risk factors leading to Pulmonary hypertension
Pulmonary hypertension can affect adults at any age, especially between the ages of 30 and 60, as it becomes more common among people who suffer from heart or lung conditions. Not only with these conditions, PH may also appear in people with other medical conditions and with the growing age. And, a Group type 1 of PH, Pulmonary arterial hypertension is more common in younger adults in these years.
The risk factors that may lead to conditions like Pulmonary hypertension include:
- A family history of the same condition
- Smoking
- Being overweight
- Living at a high altitude
- Having a blood-clotting disorder or family history with the exact condition of blood clots in the lungs
- Exposure to asbestos
- A heart condition that you're born with (A congenital heart defect)
- Using certain medications, including illegal drugs such as cocaine, methamphetamine or some weight-loss medicines.
Complications Related to Pulmonary Hypertension:
These are some complications that one may face while suffering from Pulmonary hypertension:
Enlargement of Right-sided heart and heart failure:
The condition is also known as cor pulmonale. Under this condition, the heart's right lower chamber gets larger. It makes it harder for the heart to pump blood as the chamber has to pump blood through the narrowed or blocked lung arteries. As a result, the heart walls thicken, and the right lower chamber stretches to increase the amount of blood it can hold. These changes cause more strain on the heart and eventually risk the failure of the right lower heart chamber of the heart.
Irregular heartbeats:
Pulmonary hypertension can lead to conditions like arrhythmias by causing changes in your heartbeat. This condition can also be life-threatening.
Blood clots:
Having PH may increase the risk of having blood clots in the small arteries of the lungs.
Bleeding in the lungs:
Pulmonary hypertension may cause bleeding into the lungs and coughing up blood.
Pregnancy complications:
Having a Pulmonary hypertension problem can be life-threatening for the mother and the developing baby in a pregnancy.
Treatment for Pulmonary hypertension:
The treatment of Pulmonary hypertension(PH) depends on your type of PH and other medical conditions. A healthcare professional team will suggest a suitable treatment for your individual needs.
Right till, only two types of Pulmonary hypertension (PH) can be treated directly. They include:
- Pulmonary artery hypertension (PAH).
- Chronic thromboembolic pulmonary hypertension (CTEPH).
Treatment for other types of Pulmonary Hypertension takes place by managing the underlying medical conditions.
Treatment for pulmonary arterial hypertension (PAH) are:
- Calcium channel blockers
- Oxygen therapy
- Diuretics
- Pulmonary vasodilators
Treatment for Chronic thromboembolic pulmonary hypertension (CTEPH) includes:
- Anticoagulants
- Balloon atrial septostomy (BAS)
- Balloon pulmonary angioplasty (BPA)
- Medication like soluble guanylate cyclase stimulator (SGCS)
- Pulmonary endarterectomy (PEA).
Treatment for PH due to heart or lung disorders generally focuses on managing underlying conditions. The treatment of these conditions may vary from person to person due to their individual needs. Depending on your medical condition, a healthcare professional may help you determine the best treatment plan. They may suggest.
- Dietary changes
- Oxygen therapy
- Lifestyle changes.
- Medication to manage conditions like hypertension or heart failure.
- Surgery, such as repairing heart valves.
The treatment of Group 5: PH caused by other medical conditions are still evolving. Your healthcare professional may help determine the best care plan in this situation.
The last option for a severe condition in PH includes a lung transplant.
Final lines:
Pulmonary hypertension (PH) presents a complex range of symptoms, causes, and potential complications. It is characterized by high blood pressure in the arteries of the lungs and the right side of the heart. Understanding the various forms of PH, such as pulmonary arterial hypertension (PAH) and its subtypes, may help aid appropriate treatments. Some forms have direct interventions like medications or surgical procedures. At the same time, others need management and addressing underlying heart or lung conditions. Recognizing risk factors and potential complications are essential for early diagnosis and comprehensive care. Complications like cor pulmonale, irregular heartbeats, and blood clots may help identify PH. Treatment options, ranging from pharmaceuticals to lifestyle changes, aim to improve the quality of life and manage the condition effectively. Advanced cases may require lung transplant consideration. Consulting with healthcare professionals is crucial for personalized care and optimal outcomes.
