What is Pulmonary Hypertension?

Your heart is a pressurized pumping system. The right side of your heart pumps blood through small arteries, or blood vessels, through the lungs. The lungs add oxygen to the blood which returns through the left side of your heart where the oxygenated blood is passed throughout your body.

If the small arteries or blood vessels become blocked or smaller, it restricts the amount of blood being pumped through your lungs causing pressure to increase in the right side of your heart. The right side of your heart will swell as it works harder to pump the blood. This is called pulmonary hypertension or PH.

What is the difference between PH and PAH?

Pulmonary Hypertension or PH simply refers to elevation of blood pressure in your lungs. Pulmonary Arterial Hypertension or PAH is a sub-group of PH caused by narrowing of the blood vessels in the lungs. Most PH is not PAH, and in these cases, PH is usually a result of other diseases. Most frequently, this is heart failure or other lung disease, in these cases treatment focusses on these problems.

In contrast, PAH occurs in isolation and is very rare. It is only effectively treated with specialized medicines and there currently is no cure. Our Pulmonary Hypertension Center initially focusses on determining the cause of your PH. If we find that you have PAH, we will prescribe and monitor specialized treatment. If you do not have PAH, we will make recommendations for your primary care provider, cardiologist, or pulmonologist to follow.

Symptoms

PH may cause you to be light-headed or short of breath. Symptoms of pulmonary hypertension may come and go. You may also experience:

  • Swelling in your ankles and legs
  • Fatigue
  • Weakness
  • Chest pain or pressure

What causes PH?

Not all causes of pulmonary hypertension are known. Some causes may include low oxygen levels in the blood over a long period of time, lung disease such as COPD or pulmonary fibrosis, diet drugs, congestive heart failure, obstructive sleep apnea, and HIV infection.

Some forms of pulmonary hypertension are the result of other diseases, like heart failure or sleep apnea and in these cases treatment is targeted at these medical problems.

Testing for PH

Pulmonary hypertension can take several months to diagnose. Symptoms to discuss with your physician include swelling in your ankles or legs, chest pain, dizziness, fatigue and weakness. Your physician will rule out other diseases with similar symptoms, such as Asthma.

Your physician will perform a physical evaluation listening to your heart and breathing, the color of your skin and lips and look for swelling. Your physician may order blood tests, chest x-ray, chest CT scan, Echocardiogram, ECG, pulmonary arteriogram, sleep study, or other diagnostic evaluations.

In order to confirm the diagnosis, a right heart catheterization (a test that measures the pressure in the lungs directly) is usually needed before therapy can be started.


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