Pulmonary hypertension symptoms, causes, diagnosis and treatment guidance.

Overview

What is pulmonary hypertension?

• Pulmonary hypertension (PH) is high blood pressure in the blood vessels that carry blood from the heart to the lungs (pulmonary arteries)
• Over time, these blood vessels become narrow, stiff or blocked, making it harder for blood to flow through the lungs
• This increases pressure in the lungs and makes the right side of the heart work harder

Why is it important?

Pulmonary hypertension is a serious condition. If not treated early, it can weaken the right side of the heart and may lead to heart failure.

Early diagnosis and treatment can help control symptoms and improve quality of life

What causes pulmonary hypertension?

There are several causes of pulmonary hypertension. Common causes include:

Heart conditions Long-term lung diseases Blood clots in the lungs Diseases that affect the body's immune system Sleep apnoea (breathing problems during sleep) Some medicines or inherited conditions Sometimes, the cause is not known

Who is at risk?

The risk of pulmonary hypertension may be higher in people with:

• Smoking habit
• Family history of pulmonary hypertension
• Overweight
• Diseases that affect the body's joints, skin or blood vessels
• Down syndrome (a genetic condition present from birth)
• HIV infection
• Use of certain weight-loss medicines
• Use of illegal or recreational drugs

Signs and symptoms

Symptoms of pulmonary hypertension may develop slowly and can worsen over time.

Common symptoms include:

• Shortness of breath, especially during activity
• Tiredness or fatigue
• Chest pain or pressure
• Dizziness or fainting
• Swelling in the ankles, legs, tummy or neck
• Fast or irregular heartbeat
• Blue lips or fingers in severe cases

Possible complications

If pulmonary hypertension becomes severe, it may lead to:

• Right-sided heart enlargement and heart failure
• Irregular heartbeats
• Blood clots
• Bleeding in the lungs
• Complications during pregnancy

Warning signs

Seek urgent medical help if you have:

Very fast heartbeat that does not slow down Fainting or loss of consciousness Severe breathlessness even while resting Sudden severe chest pain Sudden severe headache Sudden weakness in the arms or legs

Tests to diagnose pulmonary hypertension

Pulmonary hypertension can be difficult to diagnose because symptoms are similar to many other heart and lung conditions.

Some of the tests include:

• Echocardiogram: Uses sound waves to check heart function and estimate pressure in the lungs
• ECG (electrocardiogram): Checks the electrical activity of the heart
• Chest X-ray: Shows the lungs, heart and blood vessels
• Computed tomography (CT) or Magnetic resonance imaging (MRI) scan: Provides detailed pictures of the lungs and heart
• Lung function tests: Measure how well the lungs are working
• Right heart catheterisation: A specialised test used to confirm pulmonary hypertension and measure pressure in the lung arteries.

Treatment

There is currently no cure for pulmonary hypertension, but treatment can help control symptoms, slow disease progression and improve quality of life.

Medicines

Doctors may prescribe medicines to:

• Relax and widen lung blood vessels
• Reduce fluid build-up
• Prevent blood clots
• Improve oxygen supply
• Lower strain on the heart

Examples include Sildenafil, Tadalafil, Diuretics, etc.

Oxygen therapy

Some patients may need oxygen therapy to help improve oxygen levels in the body.

Surgery or procedures

If medicines do not improve symptoms, some patients may need surgery or other procedures.

• Pulmonary endarterectomy: A surgery to remove old blood clots from the blood vessels in the lungs
• Balloon pulmonary angioplasty: A procedure where a small balloon is used to open blocked blood vessels in the lungs and improve blood flow and breathing
• Atrial septostomy: A small opening is made between the upper chambers of the heart to reduce pressure on the heart. This procedure may help improve symptoms
• Lung or heart-lung transplant: In severe cases, a lung transplant or heart-lung transplant may be needed. After transplant surgery, medicines must be taken for life to help the body accept the new organ

Lifestyle tips for patients with pulmonary hypertension

Eat a healthy diet with fruits, vegetables, whole grains and less salt

Stay active with light or moderate exercise as advised by your doctor

Maintain a healthy weight

Do not smoke and avoid second-hand smoke

Get enough rest to help reduce tiredness

Avoid high altitudes, as they can make breathing problems worse

Avoid very hot baths, saunas or heavy lifting, which may lower blood pressure and cause fainting

Tell your doctor about all medicines you take

Go for regular health check-ups and report any new symptoms

Keep vaccinations (for common viral lung infections) up to date to help prevent infections

Speak with your doctor before planning a pregnancy, as pulmonary hypertension can cause serious complications during pregnancy

Myths and facts

FAQs