Pulmonary Hypertension
Pulmonary hypertension (PH) is a chronic and progressive disease characterised by high blood pressure in the arteries of the lungs.
PH causes the pulmonary arteries to narrow, thicken, or become blocked, making it difficult for blood to flow through the lungs which reduces oxygen supply to the body, leading to increased pressure on the heart.
With pulmonary hypertension, the pressure on the pulmonary arteries rises above normal levels, putting strain on the right side of the heart. This can eventually lead to heart failure or other significant health issues if left untreated. People with PH may experience a range of symptoms that can impact daily activities and overall health.
At North Brisbane Sleep and Thoracic in North Lakes, Brisbane, our lung specialist Dr Fiene is trained in dealing with Pulmonary Hypertension issues.
Types of Pulmonary Hypertension
PH can be classified into several groups based on its underlying cause
- Pulmonary Arterial Hypertension (PAH): This type occurs when the arteries in the lungs become narrowed, leading to increased pressure. PAH can be idiopathic, heritable, or associated with other conditions such as connective tissue diseases or congenital heart defects.
- Pulmonary Hypertension Due to Left Heart Disease: Caused by left-sided heart conditions, such as left ventricular dysfunction or valve diseases.
- Pulmonary Hypertension Due to Lung Diseases or Hypoxia: Conditions like chronic obstructive pulmonary disease (COPD) or interstitial lung disease can lead to PH.
- Chronic Thromboembolic Pulmonary Hypertension (CTEPH): Caused by chronic blood clots in the lungs.
- Pulmonary Hypertension with Unclear Multifactorial Mechanisms: Includes PH due to various other causes not covered by the above categories.
Causes and Risk Factors
Causes of pulmonary hypertension include
- Inherited genetic mutations
- Idiopathic (no identifiable cause)
- Connective tissue diseases
- HIV infection
- Blood clotting in the lungs
- Liver disease
- Congenital heart disease
- Other lung diseases – chronic obstructive pulmonary disease (COPD), sleep apnoea, pulmonary fibrosis
Risk factors for pulmonary hypertension include
- Family history of PH or other lung conditions
- Pregnancy
- Continuous exposure to high altitudes
- Smoking and drug use
- Conditions like heart disease, lung disease, and blood clotting disorders
- Exposure to certain toxins
- Obesity
- Obstructive sleep apnoea
Symptoms of Pulmonary Hypertension
Pulmonary hypertension can present with a variety of symptoms, often developing gradually and worsening over time.
Common symptoms include:
- Shortness of breath, especially during activity
- Fatigue
- Dizziness or fainting spells
- Chest pain, pressure, or discomfort
- Swelling in the ankles, legs, and eventually the abdomen
- Rapid or irregular heartbeat (palpitations)
- Bluish colour to the lips and skin (cyanosis)
Recognising these symptoms early is critical for timely diagnosis and treatment, which can slow disease progression, improve symptoms, and enhance quality of life. Without treatment, pulmonary hypertension can lead to severe complications, including right-sided heart failure and potentially death.
If you experience any of the above symptoms, contact the lung specialists at North Brisbane Sleep and Thoracic for personalised treatment.
Diagnosis of Pulmonary Hypertension
Diagnosing pulmonary hypertension involves a series of tests and procedures to confirm the condition, determine its severity, and identify any underlying causes. Accurate diagnosis is essential for effective treatment planning and management. Here are the key diagnostic tests and procedures used:
- Echocardiogram: Ultrasound of the heart to assess heart function and measure pulmonary artery pressure.
- Right Heart Catheterisation: Measures the pressure in the pulmonary arteries directly.
- Blood Tests: Help identify underlying conditions and assess organ function.
- Pulmonary Function Tests: Evaluate lung function and capacity.
- Chest X-ray and CT-Scan: Visualise the lungs and heart structures.
These diagnostic tests provide detailed information about heart and lung function, pulmonary artery pressure, and potential underlying causes. They are essential for confirming a PH diagnosis and determining its severity.
Treatment Options for Pulmonary Hypertension
Medications
- Vasodilators: Help open narrowed blood vessels.
- Endothelin Receptor Antagonists: Block endothelin, a substance that causes blood vessels to constrict.
- Prostacyclin Analogues: Mimic the effects of prostacyclin, a natural substance that dilates blood vessels.
- Phosphodiesterase-5 Inhibitors: Relax blood vessels in the lungs.
Other Treatments
- Oxygen Therapy: Provides supplemental oxygen to improve breathing.
- Diuretics: Reduce fluid buildup in the body.
- Anticoagulants: Prevent blood clots.
Identifying the specific type and cause of PH is crucial for selecting the most effective treatment as treatment strategies may differ across different types of the condition. Each patient’s condition is unique, requiring a tailored treatment plan, ensuring the most effective management of symptoms to improve quality of life.
Management and Living with Pulmonary Hypertension
Lifestyle Modifications
- Diet: Maintain a healthy diet low in salt.
- Exercise: Engage in moderate physical activity as tolerated.
- Avoiding Triggers: Steer clear of high altitudes, smoking, and exposure to certain medications.
Consistent medical follow-up is essential to monitor disease progression and adjust treatments as needed. Regular check-ups help manage symptoms effectively and prevent complications.
Support Systems
- Family and Friends: Emotional and practical support.
- Support Groups: Connect with others facing similar challenges.
- Counselling: Professional guidance to cope with emotional stress.
Prognosis and Outlook
Pulmonary hypertension is a chronic and progressive disorder. Prognosis varies based on the type, underlying cause, and how early the disease is diagnosed and treated. Most types of PH can be managed effectively once the cause is identified, however, when the cause is idiopathic, prognosis is poor. Early-stage PH has a better prognosis, while effective management of the disease and other comorbidities can also improve prognosis outcomes. New therapies and a better understanding of the disease contribute to more effective management.
When to Seek Medical Help
Warning signs that require immediate medical attention include:
- Severe shortness of breath, unrelieved by rest.
- Sudden and severe chest pain.
- Unexplained or frequent
- Rapid increase in swelling of the legs or abdomen.
If you experience any of these symptoms, contact North Brisbane Sleep and Thoracic on 1300 391 820.
Frequently Asked Questions (FAQs)
No. Pulmonary hypertension specifically refers to high blood pressure in the arteries of the lungs, whereas regular high blood pressure affects the arteries throughout the body.
There is sadly no cure for pulmonary hypertension, but treatments can manage symptoms, improve quality of life and improve survival duration. For a limited number of highly selected patients, lung transplantation may be considered.
Some forms of pulmonary hypertension can be hereditary. If you have a family history of the condition, discuss it with your doctor.
Yes, lifestyle changes such as a healthy diet, regular exercise, and avoiding smoking can help manage symptoms and improve overall health.
Avoid high altitudes, smoking, and medications that can worsen the condition. Always consult your doctor before starting new medications or supplements.
By understanding pulmonary hypertension and its management, individuals can take proactive steps to improve their health and quality of life. Early detection, personalised treatment, and ongoing support are key to living well with PH.
Contact the lung doctors at North Brisbane Sleep and Thoracic in Brisbane to begin your treatment for pulmonary hypertension.
Contact us to book an appointment
Visit us at either our Clayfield or North Lakes locations and experience compassionate care in a comfortable environment, tailored to meet your unique needs.
