Lung Condition: Pulmonary Hypertension

Pulmonary hypertension is a specific type of high blood pressure that affects the arteries in your lungs and the right side of your heart, also known as your pulmonary arteries. This forces the ventricles of the heart to work harder in order to pump blood into your lungs, which over time causes it to weaken and eventually fail.

A healthy heart has two upper chambers known as the atria, and two lower chambers called the ventricles. When blood passes through the heart, the right ventricle uses the pulmonary arteries to carry blood to the lungs. Changes in the cells that line the pulmonary arteries can cause the arterial walls to become stiff, swollen, or thick.

When this occurs, blood flow to the lungs may become slowed or blocked, which causes pulmonary hypertension. This disease is classified into five groups, depending on what causes it.

This form of pulmonary hypertension is caused by left-sided heart valve diseases, such as mitral valve or aortic valve disease. It can also be due to failure of the lower ventricle.

This form can be caused by chronic obstructive pulmonary disease (COPD), scarring of the tissue between the lung’s air sacs, known as pulmonary fibrosis, obstructive sleep apnea (OSA), or long term exposure to high altitudes in people who already have increased risk of developing pulmonary hypertension.

For this form, causes include chronic blood clots in the lungs, known as pulmonary emboli, or other clotting disorders.

This form can be caused by many different health conditions, such as blood disorders, inflammatory disorders, metabolic disorders, kidney disease, and tumors pressing against the pulmonary arteries.

Eisenmenger syndrome is a congenital heart disease that causes pulmonary hypertension due to a large hole in the heart between the two ventricles, known as a ventricular septal defect. This hole causes blood to flow incorrectly in the heart, as oxygen-rich and oxygen-poor blood mix before returning to the lungs instead of flowing throughout the body. This increases the pressure in the pulmonary arteries and causes pulmonary hypertension.

Factors that increase your risk of pulmonary hypertension include growing older, as this disease is most often diagnosed in people aged 30-60. Other factors include family history, being overweight, blood-clotting disorders, exposure to asbestos, congenital heart disease, drug use, living at a high altitude, and use of SSRIs.

For pulmonary hypertension, symptoms develop slowly over time, so in many cases they may go unnoticed for months or even years. Symptoms worsen as the disease progresses, and these symptoms include chest pain, dizziness, fatigue, shortness of breath during physical activity and eventually during rest, heart palpitations, blue lips and skin, and swelling in the ankles, legs, and abdomen.

Pulmonary hypertension can lead to many potential complications, such as an enlarged heart or heart failure, blood clots, irregular heartbeats, internal bleeding in the lungs, and pregnancy complications.

There are many tests that can be conducted to determine if you have pulmonary hypertension, although it is a difficult disease to diagnose early due to a lack of symptoms early on. To diagnose this disease, your doctor will begin with a physical exam. Your doctor may then order a blood test, chest X-ray, electrocardiogram, or echocardiogram. If the echocardiogram shows signs of pulmonary hypertension, your doctor will likely order a right heart catheterization to confirm the results.

Other tests that may be ordered include a CT scan, MRI, pulmonary function test, sleep study, V/Q scan, or open-lung biopsy. Your doctor can also recommend genetic screening if you have a family history of this disease.

Although there is no cure for pulmonary hypertension, treatment options are available to slow the progress of the disease. When pulmonary hypertension is caused by another condition, treatment is given for the underlying cause. Many medications exist to treat this disease, such as vasodilators, GSC stimulators, blood vessel widening medicine, calcium channel blockers, blood thinners, and water pills.

If medications are not enough to control your symptoms, your doctor may recommend surgery. Surgeries to treat pulmonary hypertension include atrial septostomy, which is a form of open heart surgery that creates an opening between the atria to relieve pressure on the right side of the heart, or a heart or heart-lung transplant.

Lifestyle changes you can make to help prevent developing this disease include staying active, avoiding tobacco smoke and high altitudes, eating a healthy diet, and getting any recommended vaccines. If you are already suffering from pulmonary hypertension, there are also things you can do at home to ease your symptoms, such as getting enough rest, avoiding situations that lower your blood pressure to extreme levels, and getting regular checkups.

At Gwinnett Pulmonary and Sleep, we offer services to help determine if you are dealing with lung conditions such as pulmonary hypertension, and treatment to help if you are. These services include pulmonary function tests, such as spirometry, lung volume, and diffusion capacity; as well as pulmonary rehabilitation.

If you suspect that you may have pulmonary hypertension, it’s important to get tested as soon as possible. Learn more about our services here, or schedule an appointment to talk to our doctors.