What pulmonary hypertension really is

Pulmonary hypertension refers to high blood pressure that occurs in the arteries supplying blood to the lungs. These structures are called pulmonary arteries. Symptoms shown by patients with pulmonary hypertension include dizziness, fainting and frequent shortness of breath. Most of these symptoms become worse when the patient exerts himself.

Pulmonary blood pressure can rise because the blood vessels become constricted and their walls thicken. This has the effect of narrowing the passage through which blood must travel. The decrease in the carrying capacity of blood vessels elevates blood pressure.

The heart has pump harder in order to get blood moving through the pulmonary arteries. The resistance to blood flow through the arteries may be high enough to significantly decrease the amount of blood flowing to the lungs, despite the extra effort put forth by the heart. When blood supply to the lungs decrease, it causes symptoms like dizziness, shortness of breath, etc.

The term primary pulmonary hypertension is used when the hypertension has no known cause. Secondary pulmonary hypertension means high blood pressure caused by another medication condition like for example, a congenital heart defect.

Additional symptoms of this type of hypertension include a general feeling of tiredness or fatigue and swollen limbs, especially swelling around the ankles or feet. A non-productive cough is sometimes a sign of this condition. Some patients may cough up blood as well, although this is comparatively rare.

Pulmonary hypertension can of five types - venous, arterial, thromboembolic, hypoxic or miscellaneous.

Left heart failure that results in reduced pumping efficiency of the heart is one of the most common causes of pulmonary venous hypertension. Inefficient heart action results in blood not leaving the pulmonary circulation system quickly enough, which results in high blood pressure in the pulmonary vein and artery.

Pulmonary arterial hypertension of often caused by autoimmune diseases like HIV. It can also have other causes like congenital heart disease and sickle cell disease.

Treatment of pulmonary hypertension will depend on the type of the disease - whether it is venous, arterial, hypoxic, etc. As mentioned earlier, pulmonary arterial hypertension is often caused by heart failure. Thus, treatment for this condition may consist of improving the function of the heart's left ventricle. Medications like diuretics, ACE inhibitors and beta blockers are often used for this purpose. Defective valves of the heart may also be surgically repaired or replaced.

Doctors may recommend lifestyle modifications for patients with pulmonary arterial hypertension. Drug therapy using oral anticoagulants, digoxin or diuretics may be used. The patient may be given supplemental oxygen. It is not clear whether these types of treatment are useful enough - trials have shown that they are not uniformly effective.

Patients with thromboembolic pulmonary hypertension are sometimes treated using a surgical procedure called pulmonary thromboendarterectomy (abbreviated PTE). It involves removing a clot (or thrombus) and the lining of the pulmonary artery. This procedure has a fairly high success rate. On the flip side, it is a very complex procedure and is done only at a few surgical centers.

Survival rates of patients with pulmonary hypertension have dramatically improved in recent decades. Earlier detection of the disease probably has a lot to do with it. Newer, more effective drugs and improved care also contribute to better survival rates.

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