Author: Dr. Estela Apolinar
Answer: Pulmonary HTN is high blood pressure involving the vessels that carry blood from the heart to the lungs. These vessels can become scarred and constricted, thereby making it difficult for the heart to pump blood through them. The pressure the heart must exert to pump blood from the heart through these arteries increases over time. Eventually, the right side of the heart enlarges and weakens, leading to heart failure.
Certain clinical conditions are known to cause Pulmonary Hypertension. These include valvular heart disease, blood clots to the lungs, COPD, emphysema, and pulmonary fibrosis. More rarely, HIV, Lupus, rheumatoid arthritis, scleroderma, or liver cirrhosis may contribute to this disorder. Unrecognized sleep apnea has also been associated with progressive pulmonary hypertension.
Often, patients may remain asymptomatic for some time. The most common symptoms that eventually develop include shortness of breath, chest pain, swelling of the legs, loss of consciousness, increased abdominal girth, fatigue or change in exercise capacity.
If you have any of the symptoms above, it is important to see your physician. A thorough history and physical examination, along with an EKG, are helpful. An ultrasound of the heart can lead us to suspect pulmonary hypertension. However, confirmation of this disorder is best made by measuring the pressure in the heart by a right heart catheterization. Both of these studies can be done by a cardiologist.
The treatment varies depending on the cause of pulmonary hypertension. There are new medications that lower the blood pressure in the lungs by relaxing these vessels. Oxygen – and sometimes blood thinners – are part of the treatment. Please consult with a cardiologist for more details regarding treatment options.