Pulmonary hypertension is a type of high blood pressure (hypertension) that specifically affects the arteries which supply the lungs and the heart. It is a serious condition that can impair the walls of the pulmonary arteries, preventing their ability to function properly – and over time, this can cause damage to the right side of the heart. Although there is no cure for pulmonary hypertension, treatment can help to improve symptoms and slow down the progress of the condition.
The heart is made up of two lower chambers (ventricles) and two upper chambers (atria). Each time blood passes through the heart, the right ventricle pumps blood to the lungs via a large blood vessel, known as the pulmonary artery. However, if the walls of this artery and the other arteries around the heart become thick, stiff, and swollen, it can eventually slow down or block blood flow through the lungs – causing pulmonary hypertension. Reduced blood flow means the right ventricle has to work harder to pump blood through the arteries, which can cause the heart to become weaker and can lead to permanent damage.
The cause of the changes in the pulmonary arteries that lead to pulmonary hypertension can be lung diseases such as COPD (chronic obstructive pulmonary disease), obstructive sleep apnea, blood clots, and problems with the smaller arteries.
Symptoms of Pulmonary Hypertension
Symptoms of pulmonary hypertension are not always obvious until the condition becomes much more advanced, but they can include:
- Shortness of breath (dyspnea)
- Tiredness/fatigue
- Dizziness, fainting, or feeling faint
- Chest pain or pressure
- Racing heart (palpitations)
- Swelling (edema) in the legs, ankles, feet, and/or abdomen
- Bluish color of the lips and skin (cyanosis)
Symptoms also typically get worse during exercise.
How Is Pulmonary Hypertension Diagnosed?
Pulmonary hypertension is hard to diagnose in its early stages because it isn’t always detected in routine physical exams. Even when the condition is more advanced, it tends to share similar signs and symptoms as many other heart and lung conditions.
To diagnose pulmonary hypertension, your doctor will perform a physical exam, review your personal medical history and your family’s medical history (parents and siblings) to check for susceptibility to heart or lung issues, and perform one or more tests. These tests may include:
- A chest X-ray to check for abnormalities, such as an enlarged right ventricle, enlarged pulmonary arteries, and other lung or heart conditions.
- An echocardiogram is done to determine how well the heart and valves are working, and it can measure the blood pressure in the pulmonary arteries. Sometimes the test may be carried out while exercising.
- An electrocardiogram (EKG or ECG) shows the heart’s electrical patterns, and it can detect abnormal heartbeats or signs of strain on the right ventricle.
- Heart catheterization to directly measure the pressure in the pulmonary artery and right ventricle.
- Pulmonary function test to assess airflow in and out of the lungs, and to measure how much air the lungs can hold.
- A sub-maximal heart and pulmonary evaluation (SHAPE) test to assess exercise tolerances and responses. This determines whether exercise intolerance is related to pulmonary disease, cardiac disease, or lack of physical conditioning.
Your doctor may also request other tests such as a blood test, a six-minute walking test, and diagnostic imaging tests such as a CT scan, an MRI, or a ventilation/perfusion (V/Q) test.
What Are the Possible Treatments?
Finding the most appropriate treatment can take time, and it can be complex. If your pulmonary hypertension is caused by another condition, such as sleep apnea, treatment will be given for the underlying cause. Otherwise, treatment for pulmonary hypertension can include:
- Medications to relax and open narrowed blood vessels and to lower blood pressure, or to prevent blood clots – such as guanylate cyclase stimulators, blood vessel dilators (vasodilators), or endothelin receptor antagonists.
- Lifestyle changes, such as stopping smoking, weight management, dietary changes, regular (appropriate) exercise, and avoiding certain medications/activities that can interfere with the condition or make symptoms worse.
- Surgery in severe cases, or if other treatments do not improve the symptoms, surgery may be necessary to relieve pressure on the right side of the heart.
Lung Specialists in Weatherford, Texas
Here at the Lung & Sleep Specialists of North Texas, we provide comprehensive diagnosis and treatment of pulmonary conditions of all kinds, including pulmonary hypertension. We are board-certified in internal medicine, pulmonary care, sleep medicine, and critical care and we develop our treatment plans to encompass the whole person, not just to treat isolated symptoms.
If you have any questions or would like to schedule an appointment, call us today at (817) 594-9993 or fill out our appointment request form online now. We look forward to being your healthcare partner!