Pulmonary Hypertension

Pulmonary HypertensionPulmonary hypertension is a lung disorder that occurs when the arteries that carry blood from your heart to your lungs narrow, causing blood pressure to rise far above normal levels. Symptoms may develop so slowly that pulmonary hypertension can go undiagnosed for years. It may be hereditary or be caused by heart disease, liver disease, rheumatic disorders (such as lupus), a blood clot in a pulmonary artery, or lung conditions, such as emphysema, COPD, or pulmonary fibrosis. Obesity and sleep apnea may also lead to developing pulmonary hypertension.

According to the American Lung Association, there are an estimated 300 new cases of primary pulmonary hypertension each year. It is more common in women, non-Hispanic blacks, and in people ages 75 or older.

Common symptoms include shortness of breath, fatigue, dizziness, chest pain, a racing heartbeat, or swelling in the ankles, abdomen, or legs. Normal pressure in pulmonary arteries in people at rest is 8-20 millimeters of mercury (mmHg). In people with pulmonary hypertension, the average pressure in the pulmonary arteries is 25 mmHg or higher.

To diagnose pulmonary hypertension, doctors may perform a complete medical history and physical exam that includes listening for abnormal heart sounds, examining the jugular vein in the neck for swelling, and looking for signs of fluid retention, poor oxygenation, or other conditions that could cause pulmonary hypertension. Blood tests, pulmonary function tests, pulmonary angiograms, exercise tolerance tests, ventilation perfusion scans, chest x-rays, chest CT scans, heart catheterization, and other tests may help identify the condition and the best approach to individual treatment.

Treatment options can include oxygen, blood thinners, diuretics, potassium, digoxin, or medications that dilate pulmonary arteries, lower pulmonary blood pressure, block the action of substances that cause narrowing of lung blood vessels, or relax pulmonary smooth muscle cells. Surgery may be warranted if a large clot is found in the pulmonary artery, or if a patient is a candidate for organ transplantation.

Read more about pulmonary hypertension from the American Lung Association.