Pulmonary Hypertension (PH) is a rare but life-threatening disease that affects the pulmonary arteries, which are the vessels responsible for carrying blood from the heart to the lungs. The disease is characterized by high blood pressure in the lungs, as well as narrowed and blocked arteries and capillaries. It is a disease that generally gets worse over time and may even result in death. There is currently no cure for pulmonary hypertension, but there are treatments that can help improve patients’ quality of life and reduce symptoms.
Patients with pulmonary hypertension often experience shortness of breath (dyspnea), fatigue, dizziness or fainting spells (syncope), pressure or pain in the chest, swelling (edema) in the ankles, legs and abdomen (ascites), bluish color to the lips and skin (cyanosis), and irregular heartbeat. However, the symptoms of the disease can go unnoticed or mistaken for years. The development of the disease can be related to other underlying conditions, but in numerous cases the reasons for PH are unknown. It is, however, known that pulmonary hypertension is closely associated with heart failure.
Development of Heart Failure Due to Pulmonary Hypertension
PH patients develop inflammation and mutations in the cells that line the pulmonary arteries. Due to these alterations, the vessels become narrowed and blood flow becomes obstructed. As a result, the heart cannot properly pump blood through the pulmonary arteries into the lungs, which increases the pressure in the arteries. Since the heart needs to work harder, the right ventricle becomes enlarged and weakened. As the heart’s function is progressively affected, it may result in right heart failure.
Heart failure is the most common cause of death in patients who suffer from pulmonary hypertension, according to the National Heart, Lung, and Blood Institute of the National Institutes of Heath (NIH). However, when caught early, heart failure can be treated with lifestyle changes, medication, devices and surgical procedures, and ongoing care to monitor both the heart’s condition and pulmonary hypertension as a possible underlying cause of heart failure, as explained by the American Heart Association.
Pulmonary Hypertension Related to Left-Sided Heart Failure
Heart failure is not only a consequence of pulmonary hypertension, but it can also serve as underlying cause for the development of pulmonary hypertension. PH due to left heart failure is is believed to be the most common cause of PH and it is included in the group II of the World Health Organization (WHO) classification for PH. Left heart disease and failure affect the left ventricle and consequently the overall capacity of the heart to properly pump blood.
According to the study “Pulmonary Hypertension Due to Left Heart Disease,” left heart disease-related pulmonary hypertension is associated with high morbidity and mortality. “Epidemiological studies of group 2 PH are less exhaustive than for rarer causes of PH such as isolated pulmonary vasculopathies, but attention for this entity is growing rapidly. Group 2 PH may be caused by passive downstream elevation in left heart pressures or by a combination of the latter with pulmonary arteriolar pathologies. Improved understanding of the perturbations in pulmonary vascular structure and function that cause PH due to left heart disease is essential to reduce heart failure morbidity and mortality.”
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