Pulmonary hypertension (PH) is a dangerous and often progressive illness marked by elevated blood pressure in the lungs’ arteries.  PH affects the pulmonary arteries, which are responsible for delivering blood from the heart to the lungs for oxygenation.

PH causes the blood arteries in the lungs to constrict, obstruct, or damage, making it difficult for blood to flow through.  If left untreated, this raises lung pressure and puts more strain on the right side of the heart, which ultimately results in right heart failure.

Causes and Types

Pulmonary hypertension may be idiopathic, meaning its cause is unknown, or it may be brought on by other illnesses like

  • Chronic lung diseases like COPD or interstitial lung disease
  • Left heart disease
  • Blood clots in the lungs (chronic thromboembolic PH)
  • Congenital heart defects
  • Autoimmune diseases like scleroderma or lupus

On underlying cause, the WHO (World Health Organization) has classified Pulmonary Hypertension into 5 groups

  1. Group 1 – Pulmonary Arterial Hypertension (PAH)
  2. Group 2 – PH due to Left Heart Disease
  3. Group 3 – PH due to lung diseases and/or Hypoxia
  4. Group 4 – Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
  5. Group 5 – PH with Unclear or Multifactorial Mechanisms

Symptoms

Symptoms are often non-specific and include:

  • Shortness of breath, especially with exertion
  • Fatigue
  • Chest pain or tightness
  • Swelling in the legs or abdomen
  • Fainting or dizziness

PH is frequently underdiagnosed or misdiagnosed since its symptoms are similar to those of other illnesses.

Diagnosis

Echocardiography, chest radiography, pulmonary function tests, and, in many cases, right heart catheterization, the gold standard for monitoring pulmonary artery pressure, are used to make the diagnosis.

Treatment

Treatment varies by form and cause, but may involve oxygen therapy and diuretics.

• Pulmonary vasodilators

 • Anticoagulants

 • In severe situations, lung transplantation may be recommended.

Conclusion

A multidisciplinary approach and early detection are necessary for the life-altering illness known as pulmonary hypertension.  Patients can benefit from better symptom control and a higher quality of life with early diagnosis and appropriate treatment.