Pulmonary Hypertension 101: Types, Causes And Symptoms

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An Overview Of Pulmonary Hypertension

Pulmonary hypertension or PAH is different from regular hypertension. It is a condition that can pose a serious threat to life. In PAH, the patient’s condition tends to deteriorate with time. There is no known cure, but the right treatment can alleviate the severity of symptoms, allowing patients to have a better quality of life.

●       What is PAH?

This is a less-common form of high blood pressure that damages the pulmonary arteries and capillaries. These are the blood vessels that go from the heart to the lungs. In PAH, the arteries in the lungs are narrow, they restrict the flow of blood to the lungs and raise blood pressure levels. As a result, the heart will work harder to pump the required blood into the lungs. This ultimately weakens the heart muscle and can lead to heart failure and death. There are 5 different types classified as GP1PAH – GP5 PAH. Some types are more treatable.

●  Causes

It’s not always possible to attribute a direct cause for this condition and it may be termed as an “idiopathic” one. Genetics can play a role in developing PH. Younger people, who live in high-altitude locations and have a family history of the condition, may be at risk;  Obesity is one of the significant risk factors. In some cases, it could be caused by other conditions such as congestive heart failure, HIV, pulmonary blood-clots, connective tissue disorders, or the continual use of drugs such as cocaine or methamphetamine, consumption of appetite-suppressant medication. Liver cirrhosis or other liver diseases, certain autoimmune diseases like lupus, rheumatoid arthritis or scleroderma, congenital heart defects, sleep apnea or other lung diseases such as emphysema, bronchitis, etc can cause PAH in some patients.

Early Warning Signs and Stages Of Pulmonary Hypertension

PAH is difficult to diagnose during the early stages. However, there are certain noticeable symptoms that can get worse over time and these can point in the direction of the disease. There may be symptoms such as:

●  Shortness of breath
●  Fatigue/Tiredness with no apparent cause
●  Chest pain
●  Swelling in the ankles and legs
●  Fainting
●  Dizziness
●  Rapid pulse-rate and heart palpitations
●  Bluish color on lips and/or skin
●  In later stages, swelling and fluid collection in the abdomen

 Stages of Pulmonary Hypertension 

The World Health Organization criteria divide pulmonary hypertension into four stages, based on the severity of symptoms:

●  Class 1: Symptoms are mild at this stage and don’t get in the way of normal activities and routines
●  Class 2: There are slight limitations on your physical activities. Symptoms are noticed during physical activity, but not during resting periods.
●  Class 3: There are significant limitations to physical activity. Symptoms are noticed during slight physical exertion and normal routine physical activity, but not during resting periods.
●  Class 4: The patient cannot undertake any physical activity without symptoms.    Symptoms are present during the resting period. There could be symptoms of right-side heart failure during this stage.

When Should You See A Doctor?

Though PAH is nearly impossible to diagnose in the early stages, if the symptoms are observed, it’s important to consult a doctor immediately. She/he will refer you to a specialist who can conduct certain tests to confirm the diagnosis. It’s essential that you update the doctor about your current health status and medical schedule, this will allow them to diagnose you efficiently and set up a suitable treatment plan.

Early Diagnosis And Treatment Options

Recommended tests:

●  ECG: Detects abnormal rhythms and strain in heart
●  Echocardiogram: Measures pulmonary-artery pressure, examines heart           structure/function
●  Chest X-ray: Checks for enlargement of pulmonary arteries, lower right chamber of the heart
●  MRI/CT Scan: Detects blood-clots, narrowing, and damage of pulmonary arteries
●  Right-side Heart Catheterization: Measures pulmonary-arterial and right-ventricle blood pressure
●  Blood Tests: Reveal associated substances in the blood and/or health conditions
●  Pulmonary Function Test: Measures lung capacity and airflow.
●  V/Q Scan: Detects blood-clots

Treatment

There is no known cure today for PAH, but treatment eases symptoms and reduces the risk of complications with pills, inhalers, and IV drugs
●  Prostacyclin and Soluble Guanylate Cyclase stimulators to dilate blood vessels
●  Endothelin-receptor antagonists to block blood-vessel-narrowing endothelin
●  Digoxin to increase heart-beat and pump more blood
●  Anticoagulants to prevent clot-formation
●  Oxygen
●  Surgery, lung/heart transplant in severe conditions, younger patients

Importance Of A Healthy Lifestyle To Reduce The Risk Of PH.

Maintain a symptom-diary, know your medications, keep documents/medical-records carefully.

PAH patients can reduce the risk of complications and alleviate symptoms by making certain important and permanent lifestyle changes:

Do’s

●  Regular/slow walking (with portable oxygen cans if required)
●  Frequent rest-periods
●  Eat healthy, balanced meals, avoid trans-fats, and excess salt
●  Vaccinate against flu/pneumonia
●  Lose weight
●  Get psychological/emotional  support and counseling

Dont’s

●  No over-straining, heavy work
●  Avoid pregnancy and contraceptive pills, for women
●  Quit smoking, avoid OTC medications
●  Avoid airplane-travel and living in high altitudes
●  Stay away from hot climates, hot tub baths, saunas

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