Pulmonary hypertension or PH is a condition that occurs when pressure increases inside the blood vessels located in the lungs and in the right side of the heart (the side of the heart that receives oxygen-rich blood from the lungs). Pressure increases typically begin as a result of blockages or narrowing in the smaller blood vessels in the lungs, which in turn increases the pressure inside the larger arteries and the heart itself. Over time and without proper treatment and ongoing management, pulmonary hypertension will cause the heart to weaken and become far less efficient at pumping blood, ultimately resulting in heart failure. PH can sometimes be caused by blood clots, chronic obstructive pulmonary disease (COPD) or obstructive sleep apnea (OSA), but often, the cause of PH is undetermined (or “idiopathic”).
In its early stages, pulmonary hypertension often causes very few or even no noticeable symptoms, leaving many people unaware they have the condition until it progresses to more severe and symptomatic stages. When PH does cause symptoms, they may include:
dizziness or fainting
shortness of breath
rapid or racing heartbeat
swelling in the feet, ankles and legs
cyanosis, a condition that causes a bluish tinge in the nails and lips due to decreased blood oxygen levels
Diagnosis typically is made through a cardiac ultrasound (echocardiography) or with a minimally-invasive procedure called catheterization that measures the pressure inside the right side of the heart.
So far, no cure has been developed for pulmonary hypertension, but there have been many medical advances that have made treatment much more effective. Most cases of PH can be treated with medications, and some patients will need to take combinations of more than one medicine to manage their condition and to prevent serious medical events from occurring. Regular doctor visits and evaluations will be needed to ensure the medications and their dosing remain optimized over time. In instances where medication is ineffective in managing symptoms, surgery may be needed to reduce the pressure inside the lung and the heart or to replace the lung entirely.
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