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Understanding Pulmonary Hypertension

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Dear Dr. Levister: My elderly mother has high blood pressure. She was recently diagnosed with pulmonary hypertension. Are these conditions one in the same? D.S.

Dear D.S.: Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of your heart.

Diseases that affect flow out of the heart to the rest of the body result in backflow of blood (stacking of blood) that raises pulmonary venous pressures leading to pulmonary hypertension Pulmonary hypertension begins when tiny arteries in your lungs, called pulmonary arteries, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, and raises pressure within your lungs' arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and eventually fail. Pulmonary hypertension is a serious illness that becomes progressively worse and is sometimes fatal. Although pulmonary hypertension isn't curable, treatments are available that can help lessen symptoms and improve your quality of life.

Pulmonary hypertension symptoms include: Shortness of breath (dyspnea), fatigue, dizziness or fainting spells (syncope), chest pressure or pain and swelling (edema) in your ankles, legs and eventually in your abdomen (ascites).

The treatment for pulmonary hypertension depends on the underlying cause. If left sided heart failure is the primary problem, then adequate treatment of the left heart failure by a cardiologist is the main stray of treatment. In cases where hypoxia (low oxygen levels) due to any chronic lung disease, such as COPD, is the cause, then providing oxygen and appropriately treating the underlying lung disease by a lung doctor (pulmonologist) is the first step in treatment.

In conditions, such as scleroderma, which often can cause pulmonary hypertension, a rheumatologist is involved in the treatment program.

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