Pulmonary Hypertension

Adena provides the highest quality pulmonary hypertension treatment in a patient centered environment at many of our locations across southern central Ohio.

  • Department of:
  • Adena Regional Medical Center

What is Pulmonary Hypertension?

Pulmonary hypertension is abnormally elevated pressure in the pulmonary circulation that affects the arteries in the lung and on the right side of the heart.

High blood pressure is the signature characteristic of pulmonary hypertension. Blood pressure is a measure of the force of blood against artery walls as it circulates through the body. Blood pressure can go up and down throughout the day, but extended periods of high blood pressure can cause major health issues. When you have your blood pressure taken, there are two numbers. Here’s what they mean:

  • Systolic pressure. Systolic pressure is the top number in the reading. It shows how much pressure the blood is exerting against the artery walls when the heart beats.
  • Diastolic pressure. Diastolic pressure is the bottom number in the reading. It shows how much pressure the blood is exerting against the artery walls when the heart is resting between beats.

The only way to know if you have a healthy range of blood pressure is to have it checked and to know the healthy range of blood pressure. Blood pressure numbers of less than 120/80 mm Hg are considered within the normal range.

It is important to know the difference between pulmonary hypertension and hypertension. Pulmonary hypertension is high blood pressure specifically in the arteries going to the lungs, while normal hypertension can be high blood pressure affecting any of the arteries throughout the body.

Types of Pulmonary Arterial Hypertension

Not all cases of pulmonary hypertension are the same. There are four distinct types of pulmonary hypertension – each with the own set of causes and dangers. They are as follows:

  • Pulmonary arterial hypertension (PAH)
  • Pulmonary hypertension due to left heart disease
  • Pulmonary hypertension due to lung disease
  • Pulmonary hypertension due to chronic blood clots in the lungs

Pulmonary Hypertension Symptoms

The signs and symptoms for pulmonary hypertension can go unnoticed during the early stages, but as the disease progresses they worsen. The signs and symptoms include:

  • Dyspnea (shortness of breath) while exercising, and over time happening while at rest
  • Fatigue
  • Pressure or pain in the chest
  • Certain chronic conditions and diseases, such as chronic obstructive lung disease or heart disease
  • Cyanosis (bluish hue to the lips and skin)
  • Swelling in the ankles, legs and eventually the abdomen
  • Heart palpitations or racing pulse
  • Dizziness or fainting spells

Pulmonary Hypertension Causes

For some cases of pulmonary hypertension, the cause is idiopathic (unknown). Pulmonary hypertension can occur in association with many other diseases, including lung disease and heart disease. Some common underlying causes for this condition include congenital heart disease, connective tissue disease, high blood pressure, cirrhosis of the liver, and chronic lung diseases like emphysema. Genetics also seem to play a role in pulmonary hypertension.

Certain lifestyle and behavioral factors can increase your risk of pulmonary hypertension, including:

  • Being overweight
  • Use of illegal drugs, such as cocaine
  • Taking certain appetite-suppressant medications
  • Existing risk and also living at a high altitude

Pulmonary Hypertension Diagnosis

Early diagnosis of pulmonary hypertension is difficult because symptoms are not always obvious and the disease is not usually detected during routine health exams. Even when signs and symptoms do become more obvious, the condition can easily be mistaken for another heart or lung condition with similar symptoms.

Diagnosis of pulmonary hypertension involves a review of your family and medical history, a discussion of your symptoms and a physical examination. Your doctor may order a test to confirm the diagnosis.

Testing may include:

After you’ve received a diagnosis, your doctor will classify your condition depending on the severity. The classes include:

  • Class I. You've been diagnosed with pulmonary hypertension, but you don’t experience symptoms with normal activity.
  • Class II. You don't have symptoms at rest, but you experience symptoms such as fatigue, shortness of breath or chest pain during normal activity.
  • Class III. You're comfortable at rest, but experience symptoms with physical activity.
  • Class IIII. You have symptoms with physical activity and while at rest.

Pulmonary Hypertension Treatment Options

Although there is no cure for pulmonary hypertension, the condition can be managed with medications, surgery, lifestyle changes or some combination of these treatments. Medications focus on opening the narrowed blood vessels. Options include:

  • Vasodilators
  • Endothelin receptor antagonists
  • Sildenafil and tadalafil
  • High-dose calcium channel blockers
  • Soluble guanylate cyclase stimulator
  • Anticoagulants
  • Diuretics
  • Digoxin

When medications fail, there are two types of surgery that may also help treat pulmonary hypertension, including:

  • Atrial septostomy. During this open-heart surgery, the doctor creates an opening between the upper left and right chambers of the heart to relieve pressure on the right side.
  • Transplantation. In some cases, a lung or heart-lung transplant could be an appropriate treatment option. Medications are required after this surgery to ensure your body doesn’t reject the new organ or organs.

Lifestyle modifications are always helpful when it comes to treating and managing pulmonary hypertension. Staying active, losing weight if you’re obese or overweight, smoking cessation, and sticking to a healthy diet are all great strategies.

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