Pulmonary Hypertension | Pulmonology & Critical Care | Loyola Medicine

Pulmonary Hypertension

Overview and Facts about Pulmonary Hypertension

Pulmonary hypertension, also called pulmonary arterial hypertension, is a life-threatening condition that results in high blood pressure in the arteries between the heart and the lungs. Pulmonary hypertension causes the small arteries in the lungs to narrow and to become blocked, which makes it more difficult for blood to flow through them, resulting in high blood pressure in the lungs.

This increase in blood pressure makes the heart work harder and, over time, causes the heart muscle to weaken. Eventually, pulmonary hypertension can lead to heart failure. This condition is often treated by pulmonology and critical care specialists.

Signs and Symptoms of Pulmonary Hypertension

Many patients don’t experience signs and symptoms of pulmonary hypertension until the disease progresses. One of the first symptoms is shortness of breath with activity. As the condition worsens, patients may also experience:

  • Chest pain
  • Fatigue
  • Passing out
  • Swelling in the legs

Causes and Risk Factors of Pulmonary Hypertension

Pulmonary hypertension can result from different medical conditions. Some of the most common include:

  • Congestive heart failure
  • Blood clots in the lungs
  • HIV
  • Stimulant use, such as cocaine or methamphetamine
  • Cirrhosis of the liver and other liver diseases
  • Autoimmune diseases, such as lupus and rheumatoid arthritis
  • Lung diseases like emphysema, bronchitis, or pulmonary fibrosis
  • Sleep apnea
  • Congenital heart defects

Sometimes, the underlying cause of pulmonary hypertension can’t be determined. In these cases, doctors may diagnose the condition as idiopathic pulmonary hypertension.

Tests and Diagnosis of Pulmonary Hypertension

To determine a diagnosis of pulmonary hypertension, the doctor reviews the patient’s medical history and performs a physical examination. The doctor may also ask questions about the symptoms the patient is experiencing as well as if they smoke.

The doctor may recommend specific tests, including:

  • Echocardiogram
  • CT scan
  • Ventilation-perfusion scan (V/Q scan)
  • Electrocardiogram
  • Chest X-ray
  • Exercise stress test
  • Blood laboratory testing for lupus, rheumatoid arthritis, and HIV

If testing shows that the patient may have pulmonary hypertension, a right heart catheterization will be performed.

Treatment and Care for Pulmonary Hypertension

There is no cure for pulmonary hypertension, but the doctor may be able to reduce symptoms and slow the disease’s progression. If there is an underlying cause to the condition, the doctor will treat that disease as well as the high blood pressure.

In addition, the doctor may recommend breathing exercises to strengthen the lungs or prescribe medications to help lower blood pressure in the lungs. As the patient’s condition worsens, the doctor may recommend inhalers or IV medications to help improve lung function. In extreme cases, a lung transplant or heart surgery may be necessary.

Staying active and engaging in regular exercises, even if they cause shortness of breath, are critical to long-term management of the disease.