Pulmonary hypertension (PH) is a rare but severe disease characterized by high blood pressure in the lungs. The disease affects the pulmonary arteries, which are responsible for transporting the blood from the right heart ventricle to the lungs, making them narrowed and blocked. In order to properly pump the blood, the heart needs to work harder, in danger of becoming enlarged and weakened. Ultimately, pulmonary hypertension can result in right heart failure and even death.

Many symptoms can suggest the onset of the disease, including shortness of breath (dyspnea), fatigue, dizziness or fainting spells (syncope), pain or pressure in the chest, swollen abdomen (ascites), bluish color in the lips and skin (cyanosis), or irregular heart beat. Edema, an abnormal buildup of fluid in the ankles, legs or lungs, is also among the possible signs of pulmonary hypertension.

Development of Pulmonary Hypertension and Edema

The alveoli present in the lungs are normally filled with air during the breathing process, but in certain circumstances, the alveoli may fill with fluid rather than air. There are numerous reasons for the accumulation of fluid in the lungs,  the most common being related to heart problems. Edema in pulmonary hypertension prevents oxygen from being absorbed into the bloodstream, since the heart isn’t capable of properly pumping the blood back up into the pulmonary arteries. When the blood pressure starts to raise, the fluid is pushed in the alveoli, reducing the normal oxygen movement. Swelling in the ankles or legs is associated with heart failure.

“When cardiac conditions cause edema, it is due to the development of left or right ventricular dysfunction. When pulmonary diseases initiate edema formation, it is a result of right ventricular dysfunction. A previous study from our group identified an association between bilateral leg edema and pulmonary hypertension, with many of the subjects with pulmonary hypertension having no evidence of cardiac or pulmonary disease,” as explained in the study “Bilateral Leg Edema, Obesity, Pulmonary Hypertension, and Obstructive Sleep Apnea,” authored by Robert P. Blankfield, David W. Hudgel, Amy Artim Tapolyai, and Stephen J. Zyzanski.

Pulmonary Hypertension and Edema Treatment

When a patient suffers from edema related to pulmonary hypertension, treating the primary disease is one of the first steps to prevent further complications. Despite the fact that there is no cure for pulmonary hypertension, there are treatments that can help ease symptoms and improve patients’ life expectancy. In addition, there are specific treatments for patients who develop edema as part of pulmonary hypertension. Supplemental oxygen helps patients relieve shortness of breath and is the common therapy for the condition.

Medication that can also help patients with pulmonary hypertension and edema include preload reducers, which help decrease the pressure in the heart and lungs, morphine (Avinza, MS Contin) may improve the symptoms of shortness of breath and anxiety, afterload reducers, which dilate the blood vessels and take pressure load off the heart, and blood pressure medication, which can also help reduce blood pressure. However, each diagnosis and treatment is tailored for the patient’s needs, taking into consideration the state of the disease and additional conditions.

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