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Other Names: Pulmonary Arterial Hypertension, Sporadic Primary Pulmonary Hypertension, Familial Primary Pulmonary Hypertension
Pulmonary Hypertension
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Pulmonary hypertension is a condition when the blood pressure in the arteries
of the lungs is abnormally high due to narrowing or blockage.
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- Primary or idiopathic pulmonary hypertension - In this condition a definitive
cause for the high blood pressure in the lungs can not be
found.
- Secondary hypertension - When the pulmonary hypertension results from another
condition.
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- Primary pulmonary hypertension
- Definitive cause is unknown
- Inherited predisposition may be due to a genetic defect.
- Other medical conditions like chronic liver
disease (cirrhosis), AIDS, sickle cell anemia and connective tissue
diseases such as scleroderma and lupus seem to trigger this condition
- Secondary pulmonary hypertension
- Pulmonary embolism.
- Chronic obstructive pulmonary disease
- Emphysema.
- Scleroderma.
- Sleep apnea.
- Congenital heart disease.
- Pulmonary fibrosis
- Left ventricular failure
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- Breathing difficulty especially during activity
- Chest pain
- Weakness and fatigue
- Fainting
- Dizziness and fainting spells
- Swelling of leg, ankles and abdomen
- Cyanosis
- Rapid pulse
- Palpitations
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Pulmonary hypertension is the result of greater resistance to blood
flow. As a result of the increased
workload caused by this resistance, the right side of the heart becomes enlarged.
Eventually, progressive heart failure may develop. Blood clots may develop in
the narrowed pulmonary arteries, thus further aggravating the condition. The
clots may dislodge from the pulmonary arteries and travel to to other parts
of the body like brain, heart, leg veins, kidney etc and cause serious life
threatening complications like stroke. Fluid might accumulate in the lungs
due to high pressure of blood in the pulmonary arteries. This is called pulmonary
edema and is a potentially life threatening condition. Presence of fluid in
the lungs makes it difficult for gaseous exchange to take place.
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- Medications
- Vasodilators - Drugs such as Prostacyclin (Epoprostenol) acts as a
powerful blood vessel dilator and anti-clotting
agent. This drug must be continuously
infused
through an intravenous (IV) catheter via a small pump that you wear in
a pack on your belt or shoulder.
- Endothelin receptor antagonists - These medications are present in
the form of pills such as Bosentan (Tracleer). This drug helps to relax
the muscles in the blood vessel wall.
- Calcium channel blockers -
These drugs help relax the muscles in the walls of the blood
vessel and are also used to treat
systemic hypertension. They include medications such as amlodipine
(Norvasc), diltiazem (Cardizem, Tiazac) and nifedipine (Adalat, Procardia).
- Anticoagulants - These are also called blood thinners and include drugs
such as warfarin (Coumadin). These medications help to prevent
the formation of blood clots. Since the anti-coagulants prevent normal
blood clotting,
they increase your risk
of bleeding complications such as bleeding from your gums and
intestinal tract.
- Diuretics - Also known as water pills,
these medications help remove excess fluid from your body,
which reduces the amount
of work your
heart has to do to pump the blood.
- Constant oxygen therapy might be needed.
- Consult your physician if you suddenly develop breathing difficulty which
progressively worsens and there is chest pain that has recently increased
in intensity.
- Lung transplantation - Single-lung transplant is the most common lung transplant
procedure used for people with primary pulmonary hypertension.
- General measures
- Get plenty of rest. Getting ample rest can help combat the fatigue
that may accompany pulmonary hypertension.
- Eat a nutritious and well balanced diet mainly comprising of lean
meat, fish, whole grains, fresh fruits and vegetables.
- Maintain a healthy weight.
- Quit smoking
- Stay as active as possible by doing low impact physical exercises.
- Avoid living or traveling to places at high elevation as it may aggravate
the symptoms of pulmonary hypertension.
- Reduce stress by practicing techniques like yoga,
meditation, biofeedback, warm baths, music or a good book. This can
dramatically relieve the symptoms and improve your quality of life.
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