Definition:
The pulmonary artery brings all the deoxygenated blood from the body (via the right side of the heart) into the lungs for gas exchange. Pulmonary hypertension is the condition of increased pressure (greater than 25mm Hg)within the pulmonary artery. There are two types of pulmonary hypertension: primary (cause unknown) and secondary (due to other medical conditions such as emphysema, bronchitis, congenital heart disease, and systemic lupus). Eventually, the pulmonary vessels will narrow, leading to increased workload on the right side of the heart, which then can lead to right side heart failure.
Symptoms:
- Shortness of breath (dyspnea)
- Fatigue
- Dizziness
- Fainting (syncope)
- Increased heart rate (tachycardia)
- Swelling (edema) of extremities
- Cyanotic lips and skin
- Chest pain
Diagnosis:
- Stethoscope - abnormal heart sounds emerge (initial test)
- Electocardiogram - visualization of heart's pumping action
- Pulmonary function tests - measure lung capacity and gas exchange efficiency
- Perfusion lung scan - using radioactive markers to visualize blood flow within the lungs
- Right-heart cardiac catheterization - to measure the pressure within the right heart chambers
Treatment:
- Anticoagulants (blood thinners) - better blood flow through narrow pulmonary vessels
- Diuretics - removing fluid from the body so that the heart has to do less work
- Calcium channel blockers (Tiazec, Norvasc, Nifedipine)- relax the muscles of the heart to increase efficiency of pump
- Prostacyclin (epoprostenol) - helps to dilate vessels
- Endothelin receptor antagonists (Tracleer) - works against endothelin, which constricts blood vessels
- Supplemental oxygen - increase oxygen content in body
- Thromboendarterectomy - if blood clot is the cause
- Lung Transplantation - last resort
