basics- Pulmonary hypertension- an up to date compilation

What is pulmonary hypertension?
Pulmonary hypertension is a condition that causes high blood pressure in the blood vessels that carry blood to the lungs. When this happens, the heart has to work harder. This causes people to have trouble breathing and to feel very tired.

What are the symptoms of pulmonary hypertension?
The early symptoms include:

●Trouble breathing when moving around
●Feeling very tired
Over time, you might get other symptoms, including:

●Swelling of the legs and feet
●Chest pain
●Not feeling hungry
●Belly pain
Rare symptoms include:

●Spitting up blood
●A hoarse voice
Will I need tests?
Yes. The tests depend on your symptoms and any other health problems you might have. You might get one or both of the following tests:

●Echocardiogram – This test uses sound waves to create pictures of your heart.
●Pulmonary artery catheterization – This test measures the pressure in the blood vessels that go to your lungs. Your doctor will advance a thin, flexible tube (called a “catheter”) into a blood vessel in your groin, neck, or shoulder area. The catheter goes to the blood vessels in your heart.
You might also need other tests to find what might be causing your pulmonary hypertension. These include:

●A chest X-ray or CT scan (a special kind of X-ray)
●An ECG – This test measures your heart’s electrical activity
●Blood tests
●Tests to check how well you lungs are working
●A sleep study – This test checks your breathing, oxygen level, and other body functions while you are sleeping overnight. These tests can sometimes be done at home, but they are often done in a sleep lab.
How is pulmonary hypertension treated?
Treatments include a number of different medicines. Some are injected into the skin or through a tube called an “IV.” Others are given as pills and include:

●Diuretics such as furosemide (brand name: Lasix) – These medicines help control swelling in the legs and feet.
●Warfarin (brand names: Coumadin, Jantoven) – This helps prevent blood clots in the lungs.
Your doctor might also have you use extra oxygen, which comes in a metal or plastic cylinder that you can take around with you. The oxygen flows through a tube into 2 plastic tubes that you put in your nostrils.

Some people with pulmonary hypertension are too tired to be very active. But if you can do some activity, walking or other light exercises can be helpful. Check with your doctor before you begin exercising.

People with very serious symptoms might need surgery. One option is a special type of heart surgery to make a hole in the heart to ease its workload. The other is a lung transplant or a heart-lung transplant. A transplant is a type of surgery in which a doctor replaces a diseased organ with a healthy one.

What will my life be like?
Pulmonary hypertension is a serious illness. Some cases can’t be treated, and for those that can, there is no cure. The disease gets worse over time and is likely to make it hard for you to do everyday things, like bathing and dressing. But medicines and oxygen might make you feel better and live longer. You will need to see your doctor often to check if you need to change the dose of the medicines you take.

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View all 7 comments Below 7 comments
Thanks to Dr. Puneet Chandna & Dr. (Mrs.) Chandra Kanta Gossain. more  
very nice and detailed write explains everything more  
Thank you mr chhabra. Professor kumar, i do nit see a reason for a TMT in the high risk suspects as the PH shows up as a clear symptom over a period of 2-3 years in a patient. An expreienced physician can actually try pick up the cues of Pulmonary Hypertention after a detailed history being recorded and symptoms associated with it. It actually takes about 2 years to progress into symtoms that include dyspnea ( difficulty in breathing) and fatigue, that progress to develop the signs and symptoms of severe PH or right ventricular failure (eg, exertional chest pain or syncope ( loss of consciousness) and congestion including peripheral (swelling in legs) edema, ascites, and pleural (liquid in lungs or chest wall) effusion. more  
Very Good information. Thanks a lot. more  
Thanks for details. Can Pulmonary hypertension be identified with continuous high BP and extent of BP correlated with age and by other simpler and economical tests particularly in rural areas, before going for the tests mentioned by you? Can TMT be done on such patients? is this illness reversible by medicines or otherwise? more  
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