Pulmonary hypertension (PH) is a rare but severe health condition characterized by high blood pressure in the pulmonary arteries. It is diagnosed when the arteries that transport blood from the heart to the lungs become narrowed and stiff. Due to the disease, it is more difficult for the heart to properly pump blood, making the organ overwork, and consequently become enlarged and weakened. In severe cases, pulmonary hypertension can lead to heart failure, which is why patients face a prognosis of few years of life after diagnosis.
Symptoms associated with PH include shortness of breath, tiredness, chest pain, irregular heartbeat, pain on the upper right side of the abdomen and decreased appetite. There is currently no cure for pulmonary hypertension, and over time the symptoms become more intense. There are, however, treatments that can help patients manage the disease. In addition, being aware of risk factors can also help prevent possible complications related to the disease.
Most Common Pulmonary Hypertension Complications
There are numerous types of pulmonary hypertension exacerbations that can occur, with the most common being right-sided heart failure or cor pulmonale, which is a result of the effort made by the heart to pump blood through blocked pulmonary arteries. While the first reaction of the body is to try to compensate the stress with thickened walls and an expanded ventricle, at some point, the right ventricle collapses from the overwork. Bleeding into the lungs can also occur, along with coughing up blood (hemoptysis), which in severe cases can kill.
Irregular heartbeats, also known as arrhythmias, may arise in the upper or lower chambers of the heart as consequence of pulmonary hypertension, and potentially leading to palpitations, dizziness, fainting and even death. Blood clots are also common, but are the only complication that is treatable. Clots are a natural method of the body to stop bleeding after injuries, but in pulmonary hypertension patients, they can occur with no reason in the small lung arteries. It is dangerous since it makes the arteries even more narrowed and blocked, but it is reversible with medication.
“The intricate geometry of the right ventricle, its thin-walled structure, as well as its interdependent relationship with the left ventricle make it suited to perform in a low-resistance system of the pulmonary vasculature. When the right ventricle has to pump the stroke volume against the elevated resistance in PAH, an initial adaptive response occurs in the form of myocardial hypertrophy. Enlargement soon follows in further compensatory effort of the right ventricle to maintain stroke volume by increasing preload. However, decrease in contractility results in clinical evidence of right heart failure manifested by elevated filling pressures, ascites, and low cardiac output,” Dr. Myung H. Park, MD, FACC explained in the study “Complications Associated With Pulmonary Arterial Hypertension.”
How To Prevent Complications of Pulmonary Hypertension
PH is a life-threatening condition, but there are ways of preventing complications or delaying its onset and quick progression. When untreated, pulmonary hypertension patients face a prognosis of few years of life. Following medical recommendations, making lifestyle alterations and monitoring the overall health are key to extending survival. PH therapies depend on the causes of the disease, but patients are prescribed drugs to relax the blood vessels, such as calcium-channel blockers. Other drugs like phosphodiesterase-5 inhibitors can also help improve blood flow.
Digoxin is used to strengthen the heart beat and treat heart failure, while diuretics help patients with accumulated fluid in the feet and ankles. Oxygen therapy, exercise and a healthy lifestyle are also habits that contribute to reducing the possibilities of complications related to pulmonary hypertension. In some cases, PH patients need lung transplants or heart-lung transplants to survive, but this approach is usually the last resort due to the risks of the procedure.
Suffering from another disease in addition to pulmonary hypertension can result in a faster progression of the disease. Patients who suffer from PH and scleroderma, for instance, have only 40% probabilities of surviving two years after diagnosis. Similarly, in the case of severe mitral valve disease, the possibilities are also limited and the treatment is usually only possible with surgery. Being pregnant is one of the most important risk factors, and having babies is completely discouraged in women who suffer from the disease due to the stress created by the pregnancy in the women’s body, heart and circulatory system.
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