Overview

Pulmonary  hypertension is  of  2 types-

Symptoms of  pulmonary hypertension –

• It causes difficulty  in  breathing.
• As  breathing  is the prime requirement it’s  causes difficultyour  in  talking  answer in  doing  all the routine work.
• Work  requiring  physical  stress  cannot be done.
• Its can  cause  fatigue,
• fainting,
• dizziness .
• In early  stages it may  not result in any symptoms at all.
• So  as we  mentioned  in our  previous  articles routine  check up is  mandatory.
• Nowadays  people  avoid  doing  any health  check ups.
• They say  that they are totally  normal.
• They try to  search  happiness  in  absence of knowledge.

Complications of  pulmonary hypertension –

Etiology of pulmonary hypertension –

• It  occurs  due to the  thickening  of  the  blood vessels  in  the  lungs.
• This  causes  narrowing  of the  blood  vessels  in the lungs, thus  reducing  the  volume  of  the  blood  vessels  through  which  the  blood  can flow, this  once the  blood  pressure  and  hence causes pulmonary hypertension .
• Diseases  of the  connective  tissue  called sclerosis.
• Congenital  anomalies  of the  heart.
• BMPR2 gene  mutation
• Some  toxins, drugs
• Cirrhosis  of the liver  causing  scarring
• Kidney  failure
• HIV  infection
• Pulmonary  embolism  by  blood  clots
• Sarcoidosis
• Sickle cell anemia
• Metabolic  disorders
• Aortic  stenosis
• Heart  valve  diseases
• Parasitic  infection  by  worms  like  tapeworms
• Copd
• Frequenly  climbing to  high  altitudes .
• Treatment  of pulmonary  hypertension –
• We  recommend treatment  from  a  qualified and experienced, Chest  physician, or  MD General Medicine specialist doctor.
• The  doctor  will  do  General  examination,
• Physical  examination ,
• Ask  medical  history,
• family  history,

Investigations  required-

• Chest  X-ray
• CTSCAN-Chest
• MRI -Chest
• ECG

• Treatment  depends  on  the  underlying  cause.
• The underlying  cause  should be  treated.
• Associated  medical conditions  should  also be  treated.
• Treatment  also  depends  on  the  grading  of  pulmonary hypertension  according to the  6 minutes  walk  test.
• Patient  is  asked to  do  mild  exercises  like  walking
• Walking  will  improve  the physical  quality  of  exertion. This  is  not  advisable  in  severe  cases  but  only in  mild  cases.
• Admission  to  hospital and administration  of  Oxygen.
• Those who  climb high  altitudes  should  take  oxygen  cylinders  with  them.

Drugs  for  pulmonary hypertension –

• Diuretics -these  reduce fluid  retention and  oedema in the  tissues  by  excretion  of  water and salts  in  urine .
• Digoxin -this is  used  in heart  failure  which  increases  the amount of  blood  pumped  by the  heart
• Blood  thinners  like  warfarin  which  reduce  the  risk of  formation of  blood  clots.
• Calcium  channel  blockers -Diltiazem which  causes  vasodilation by relaxation  of the  smooth  muscles in the  blood  vessels and  thus  increase in  blood  flow.
• Phosphodiasterase inhibitors  like  Sildenafil  which  increase the  blood  flow by  increasing the diameter of the  blood vessels.
• Endothelial  receptor antagonist like  bosentan  which  cause limitation in the constriction  of the  arteries .
• Inhalations of  opioids  like  iloprost  can  relieve  breathlessness .
• Surgery -Other  is  opted when there  is  no  relief  by  conservative  methods of  treatment –
• Atrial  septostomy -In  this  a  shunt  is  placed  between the  chambers  of the  heart to  increase  there  cardiac  output.
• Lung transplant.
• Combined  heart-lung transplant
• Thromboendarterectomy-this is  done  to remove blood  clots  in the coronary  arteries.
• At present  there  is  no  satisfactory  treatment  available  for  pulmonary hypertension

Eisenmenger syndrome and pulmonary hypertension
Eisenmenger syndrome is a form of congenital heart disease that leads to pulmonary hypertension. It may occur with uncorrected openings between the heart chambers. An instance of this is a significant opening in the heart between the two lower heart chambers, known as a ventricular septal defect.

The opening in the heart results in improper blood flow within the heart. Oxygen-rich blood combines with oxygen-poor blood. The blood is then sent back to the lungs instead of circulating to the rest of the body. This elevates the blood flow and pressure in the pulmonary arteries, leading to pulmonary hypertension.

Risk factors
Pulmonary hypertension is typically diagnosed in individuals aged 30 to 60. Advancing age can heighten the risk of developing Group 1 pulmonary hypertension, referred to as pulmonary arterial hypertension (PAH). PAH with an unknown origin is more prevalent in younger adults.

Additional factors that may increase the risk of pulmonary hypertension include:

A family history of the condition.
Being overweight.
Smoking.
Blood-clotting disorders or a family history of lung blood clots.
Exposure to asbestos.
A congenital heart defect, which is a heart issue present at birth.
Living at high altitudes.
Usage of certain medications, including specific weight-loss drugs and illegal substances such as cocaine or methamphetamine.

Complications
Possible complications of pulmonary hypertension consist of:

Enlargement and failure of the right side of the heart. Also known as cor pulmonale, this condition causes the heart’s right lower chamber to enlarge. The chamber must work harder than normal to pump blood through narrowed or clogged lung arteries.

Consequently, the heart walls thicken. The right lower heart chamber expands to accommodate more blood. These alterations place greater stress on the heart, leading to eventual failure of the right lower heart chamber.

Blood clots. The presence of pulmonary hypertension heightens the likelihood of blood clots forming within the small lung arteries.
Irregular heartbeats. Pulmonary hypertension can induce changes in heart rhythm, known as arrhythmias, which may be life-threatening.
Lung bleeding. Pulmonary hypertension can result in severe bleeding into the lungs, including coughing up blood.
Pregnancy complications. Pulmonary hypertension can pose life-threatening risks for both the mother and the developing fetus.