Hypertension (Pulmonary)

Pulmonary Hypertension

What is pulmonary hypertension? — Pulmonary hypertension is a condition that causes high blood pressure in the blood vessels that carry blood to the lungs. When this happens, the heart has to work harder. This causes people to have trouble breathing and to feel very tired.
What are the symptoms of pulmonary hypertension? — The early symptoms include:
Trouble breathing when moving around
Feeling very tired
Over time, you might get other symptoms, including:
Swelling of the legs and feet
Chest pain
Fainting
Not feeling hungry
Belly pain
Rare symptoms include:
Cough
Spitting up blood
Will I need tests? — Yes. The tests depend on your symptoms and any other health problems you might have. You might first get an echocardiogram. This is a test that uses sound waves to create pictures of your heart.
You might also need other tests to find what might be causing your pulmonary hypertension. These include:
Imaging tests, such as a chest X-ray or CT scan – Imaging tests create pictures of the inside of the body.
An ECG – This test measures your heart's electrical activity
Blood tests
Tests to check how well you lungs are working
A sleep study – This test checks your breathing, oxygen level, and other body functions while you are sleeping overnight. These tests can sometimes be done at home, but they are often done in a sleep lab.
Finally, you doctor might do a test called a "pulmonary artery catheterization." This test measures the pressure in the blood vessels that go to your lungs. Your doctor will put a thin, flexible tube (called a "catheter") into a blood vessel in your groin, neck, or shoulder area. Then he or she moves the catheter into the blood vessels in your heart.
How is pulmonary hypertension treated? — Treatments include a number of different medicines. Some medicines treat the symptoms of pulmonary hypertension. Others treat the pulmonary hypertension itself.
Treatments for the symptoms of pulmonary hypertension include:
Diuretics such as furosemide (brand name: Lasix) – These medicines help control swelling in the legs and feet.
Warfarin (brand names: Coumadin, Jantoven) – This is a "blood thinner" or "anticoagulant" medicine. It helps prevent blood clots in the lungs. In children, aspirin might be used instead. But not everyone needs warfarin.
Oxygen – Your doctor might have you use oxygen, which comes in a metal or plastic cylinder that you can take around with you. The oxygen flows through a tube into 2 plastic tubes that you put in your nostrils.
Exercise – Some people with pulmonary hypertension are too tired to be very active. But if you can do some activity, walking or other light exercises can be helpful. Check with your doctor before you begin exercising.
There are also medicines that treat the pulmonary hypertension itself. These might come as pills, or they might need to be given through an "IV" (a thin tube that goes into a vein) or as a shot under the skin.
People with very serious symptoms might need surgery. One option is a special type of heart surgery to make a hole in the heart to ease its workload. The other is a lung transplant or a heart-lung transplant. A transplant is a type of surgery in which a doctor replaces a diseased organ with a healthy one.
What will my life be like? — Pulmonary hypertension is a serious illness. Some cases can't be treated. Even for cases that can be treated, there is no permanent cure. For adults, the disease gets worse over time and is likely to make it hard for you to do everyday things, like bathing and dressing. For children, the disease might improve with time or it might get worse over time. Talk to your doctor to find out what to expect with your type of pulmonary hypertension.
Medicines and oxygen might make you feel better and live longer. You will need to see your doctor often to check if you need to change the dose of the medicines you take.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 17227 Version 7.0
Release: 28.2.2 - C28.105
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