Covering pulmonary hypertension symptoms, causes, diagnosis, medications, prognosis and how it works in infants
Pulmonary hypertension refers to abnormally elevated blood pressure in the arteries of the lungs. It is a raise in blood pressure in the pulmonary artery, pulmonary vein or pulmonary capillaries. Hypertension is classified into two in terms of understanding what causes high blood pressure. Medically expects have since identified essential hypertension and secondary hypertension.
Essential hypertension causes are not known in 90% to 95% of cases. Secondary hypertension is caused by primary underlying reasons which can be and often are medically related. The equivalent of essential hypertension from a pulmonary hypertension perspective is called idiopathic pulmonary hypertension which lacks any identifiable cause. This particular pulmonary hypertension affects albeit a small group of people.
The most recent World Health Organisation (WHO) classification of pulmonary hypertension has it in five types namely pulmonary arterial hypertension, pulmonary venous hypertension, thromboembolic pulmonary hypertension and miscellaneous pulmonary hypertension. The different causes of pulmonary hypertension are specifically covered later in this article after a presentation on pulmonary hypertension symptoms.
Just as malignant hypertension is dreaded and can result in death, pulmonary hypertension can be a severe disease whose endpoints would include inability to tolerate exercise and heart failure. It is recognised as a rare lung disorder occurring in all ages, races, and people of a wide spectrum of heritage or ethnic background. This is clearly in contrast with hypertension which affects people of African heritage and women beyond the age of 55 more than it does any other ethnic or racial group or sex.
Pulmonary hypertension symptoms
As is known of essential hypertension, symptoms of pulmonary hypertension largely remain dormant not until the condition has made advanced inroads in a patient. The delay in symptom manifestation naturally causes most sufferers to delay seeing a doctor even for years. Typically pulmonary hypertension symptoms in a patient with pulmonary venous hypertension presents shortness of breadth. This could be as one is laying down flat or as one sleeps. Everyday extra effort activities such as climbing elevated structures will also result in shortness of breadth. These particular symptoms are however absent in pulmonary arterial hypertension sufferers.
Other common symptoms of pulmonary hypertension would include fatigue, non-productive cough, and fainting. The following is an extensive list of symptoms that pulmonary hypertension patients may suffer;
Shortness of breadth upon exertion.
Non-productive cough - that is dry cough without sputum.
Wheezing - which is tight airways noise produced in the chest by moving air.
Angina pectoris - which is severe chest pain.
Syncope - which is temporary loss of consciousness.
Peripheral edema - swelling around ankles and feet. This maybe as a result of fluid leaking out of blood vessels into tissues. A sign of right-sided heart-failure.
Herrioptysis - coughing up blood. However, very rare in pulmonary hypertension patients
Cor pulmonale - alteration in the structure and function of the right ventricle caused by a primary disorder. This might include thickening of the right ventricle of the heart which walls could become enlarged.
Systemic sclerosis (scleroderma) - involving effects predominantly to skin and vessel walls and to a lesser extent heart, lungs, kidneys.
It must be noted that all these different symptoms will not necessarily show-up in a single patient. Some will present and some will not because of many different factors. As the disease advances pulmonary hypertension symptoms will become more pronounced. Simple activity will become a mammoth task. More symptoms such as irregular heartbeat accompanied by a strong, throbbing sensation will also appear. Modern day blood pressure machines such as those under the Omron blood pressure monitor series will be able to detect irregular heartbeat.
Pulmonary hypertension causes
In as much as pulmonary hypertension symptoms are important to doctors for a proper diagnosis, pulmonary hypertension causes are equally important to establish in order to get patients on the correct treatment path and regimen.
As noted earlier in some cases the underlying cause of the disease might remain unknown. However in the generality of cases the cause might be traced to a particular reason be it medically related or otherwise. Here are some of the known causes;
Drugs and toxins
Hypoxia - low blood oxygen levels
Left-sided heart failure - most common known cause
Thromboembolic disease - a large clot in a pulmonary artery will make way for pulmonary hypertension
Genetic predisposition - family line issues may make way for the disease. Investigating family history and background helps in seeking early treatment and prevention measures.
Pulmonary hypertension diagnosis
Existing pulmonary hypertension symptoms will certainly play an important role in arriving at a correct diagnosis. Due to the fact that pulmonary hypertension is possibly caused by underlying medical conditions, your physician will implement a total medical exam including a medical history check, physical exam and blood tests. Doctors will also carry out pulmonary function tests to establish extent of lung damage.
Pulmonary hypertension medications
Identification and isolation of pulmonary hypertension symptoms amongst other things will lead to successful pulmonary hypertension diagnosis which in turn will determine which medications to prescribe. Doctors have different hypertension medications at their disposal which often are determined by carefully following prepared hypertension guidelines. These guidelines are regularly released by leading and reputable hypertension institutions such as the WHO, the British Hypertension Society (BHS) and the American Heart Association (AHA) amongst others.
Medications for pulmonary hypertension would include Diuretics, ACE Inhibitors, Beta-Blockers and others. In treating hypertension of this nature doctors may also employ the well known hypertension diet called DASH in addition to other lifestyle changes. Other eating habits may also be recommended to include bias towards lots of fruits and vegetables with less sodium intake. For example, celery and high blood pressure have been shown to have a positive relationship beneficial to hypertension patients. Other foodstuffs and beverages such as those containing caffeine especially coffee may have to be taken in moderation or completely abandoned due to possible blood pressure spikes.
Pulmonary hypertension in infants
Infants and children can also suffer from pulmonary hypertension. In infants it may present as persistent pulmonary hypertension which is when an infant fails to carry out a smooth transition at birth in terms of its respiratory system. This transition involves relaying on the umbilical cord hosted by its mother for oxygen to relaying on own respiratory system.
At birth the pulmonary artery aught to kick in and start pumping blood to the lungs. This switch-over may fail resulting in persistent pulmonary hypertension. There are however other reasons why pulmonary hypertension may occur in infants and children. This would include some side effects of drugs used during pregnancy. This would also include smoking while pregnant. It is also possible for the cause of pulmonary hypertension to remain unknown despite efforts to establish the causes.
Pulmonary hypertension symptoms in infants and children are not far off from what is found in adults. In fact they are almost similar and are as listed;
Cyanosis - "a physical sign causing a bluish discoloration of the skin most easily observed on the lips, tongue and fingernails"
These pulmonary hypertension symptoms will not necessarily show up all at once or all of them in the same person. It will vary from individual to individual.