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Pulmonary Hypertension—Adult

(Hypertension, Pulmonary—Adult)

Definition

Pressure helps blood flow through blood vessels. Hypertension occurs when this pressure gets too high. When this happens in the blood vessels in the lungs it is called pulmonary hypertension.
Normal pressure for blood flow through the lungs is one-sixth of the pressure for the rest of the body. Pressure may rise for any number of reasons. It creates a potentially serious condition. The right side of the heart needs to pump harder to move blood against the pressure. If left untreated the right side of the heart can eventually fail.
Pulmonary Circulation
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Causes

The blood vessels in the lungs are very sensitive to oxygen. The lower the level of oxygen, the narrower the vessels become. Higher pressure will be needed to push blood through the narrow blood vessels. Pressure will also increase when there is more blood in the lungs than normal.
The increase may be caused by:
Other factors and conditions that can create pulmonary hypertension include:

Risk Factors

Factors that may increase your chance of pulmonary hypertension include:

Symptoms

Pulmonary hypertension may cause:

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a specialist in heart or lung diseases. A cardiologist focuses on the heart. A pulmonologist focuses on the lungs.
Tests may include the following:

Treatment

Most cases of pulmonary hypertension are due to another disease. In this case the underlying cause is treated.
For some, no treatable cause is found. In this case, there are several medications that might be of benefit. Talk with your doctor about the best plan for you. Treatment options include the following:

Medications

Pulmonary hypertension may be treated with:
  • Calcium channel blockers
  • Anticoagulants
  • Diuretics
  • Oxygen
  • Phosphodiesterase inhibitors
  • Prostacyclin
  • Endothelin receptor blockers

Lung Transplantation

A lung transplant may be necessary if the disease has progressed or is advanced. It is generally not considered unless other treatment methods fail.

Prevention

To help reduce your chances of getting pulmonary hypertension, take the following steps:

RESOURCES

American Heart Association http://www.heart.org

National Library of Medicine http://www.nlm.nih.gov

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Heart and Stroke Foundation of Canada http://www.heartandstroke.ca

References

Kasper DL et al., eds. Harrison's Principles of Internal Medicine. 16th ed. New York: McGraw-Hill; 2005.

Libby P, Braunwald E. Braunwald’s Heart Disease. 6th ed. Philadelphia, PA: Saunders/Elsevier; 2005.

Physicians’ Desk Reference. 59th ed. Oradell, NJ: Thomson PDR; 2005.

Rubin LJ, Badesch DB. Evaluation and management of the patient with pulmonary arterial hypertension. Annals of Internal Medicine. 2005;143(4):282-292.

Weinberger SE, Drazen JM. Disturbances of respiratory function. In: Braunwald E. Harrison's Principles of Internal Medicine. 15th ed. New York, NY: McGraw-Hill; 2001.

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