Pulmonary Hypertension Diagnosis and Treatment

Description

High blood pressure in the arteries that supply the lungs is called pulmonary hypertension (PH)
or pulmonary arterial hypertension (PAH).
The blood pressure measured by a
cuff on your arm
isn’t directly related to the pressure in your lungs.
The blood vessels that supply the lungs
constrict and their walls thicken, so they can’t carry as much blood.
As in a kinked garden hose,
pr
essure builds up and backs up.
The heart work
s harder, trying to force the blood through.
If
the pressure is high enough, eventually the heart can’t keep up, and less blood can circulate
through the lungs to pick up oxygen.
Patients then become tired, dizzy and short of breath.
If a pre

existing dise
ase triggered the PH, doctors call it secondary pulmonary
hypertension.
That’s because it’s secondary to another problem, such as a left heart or lung
disorder. However, congenital heart disease can cause PH that’s similar to PH when the cause
isn’t known,
i.e., idiopathic or unexplained pulmonary arterial hypertension.
In this case, the
PAH is considered pulmonary arterial hypertension associated with congenital heart disease,
such as associated with a VSD or ASD (either repaired or unrepaired).
The proble
m is due to
scarring in the small arteries in the lung.
It’s important to repair congenital heart problems (when possible) before permanent pulmonary
hypertensive changes develop.
Intracardiac left

to

right shunts (such as a ventricular or atrial
septal de
fect, a hole in the wall between the two ventricles or atria) can cause too much blood
flow through the lungs.
This situation is sometimes called
Eisenmenger complex
. In the past,
the holes can’t be repaired due to increased stress on the heart produced by
the high pressures
in the scarred lung blood vessels.
This situation is changing with the availability of new
medicines.
Heart valve conditions, such as mitral stenosis (a narrowing of the mitral valve), can
also cause secondary PH. Fixing the valve usual
ly reverses the PH.