Primary pulmonary hypertension (PPH) is high blood pressure in the pulmonary artery, a condition that can be treated but not cured. This artery is the one that carries oxygen in the blood to the lungs. The disease can be caused from blockages or narrowing of the arteries. When the muscles that are close by tighten up and constrict the arteries it can lead to PPH. Pulmonary hypertension symptoms include dizziness, swelling in the ankles or legs, chest pain, palpitations, fatigue, and fainting. As the disease progresses a person will experience extreme fatigue and weakness, have difficulty breathing, and may have to remain in bed most of the time. A diagnosis can be made by a physician when using several different types of tests. Treatment involves taking medication, oxygen, and for the most severe cases, lung and heart transplantation.
High blood pressure in the pulmonary artery affects the condition of the heart and the lungs. The artery is located in the right ventricle of the heart and when the pressure is high there is a strain put on the organ that can lead to other problems. In addition, the lungs may not receive enough oxygen to operate efficiently. Primary pulmonary hypertension causes changes in the small blood vessels within the lungs. The actual cause of the disease is not completely understood but some conditions that may play a role in the onset are Raynaud’s syndrome, cocaine, and HIV. The beginning signs of the condition often include extreme fatigue, difficulty breathing, and fainting spells. Because of the usual slow progression of the disease many people go undiagnosed until the condition becomes much worse. Having symptoms without a diagnosis can become a burden to the person experiencing them. “Cast thy burden upon the LORD, and He shall sustain thee: He shall never suffer the righteous to be moved.” (Psalm 55:22)
One of the medications that is used to treat high blood pressure in the lungs and help with the functioning of the heart include calcium channel blockers. Calcium channel blockers cause the arteries to relax thus improving blood flow. Vasodilators are also useful for treating pulmonary hypertension symptoms. Vasodilators are deliverable intravenously helping to lower the pressure within the artery and give the patient the capability of being more active. Anticoagulants are often used because it decreases the bloods ability to clot so the blood flows better through the arteries. Diuretics help to decrease the workload on the heart by reducing the fluid level in the body. Many patients require the use of oxygen when breathing becomes difficult. Before a heart or lung transplant is considered a physician will try medications first. If the patient doesn’t respond to meds then transplants become a last resort option.
When the cause of pulmonary hypertension is known it is referred to as secondary pulmonary hypertension (SPH). Some of the conditions that have been known to cause SPH are emphysema, bronchitis, scleroderma, and lupus. Suffering with pulmonary hypertension symptoms may be difficult to diagnose in a person who has other medical conditions simply because the symptoms of SPH may be similar to symptoms he or she is already experiencing. A doctor will normally want to know of any new symptoms that may have surfaced or if any symptoms have worsened between office visits. Three conditions that are all related to the immune system that have been linked to the disease are Raynaud’s syndrome, scleroderma, and lupus. In Raynaud’s syndrome the patient experiences sensitivity to cold causing their fingers and toes to turn blue. Scleroderma is a connective tissue disorder that affects the patient’s skin, blood vessels, and internal organs. Lupus attacks the cells and tissues causing damage to joints, blood vessels, and organs.
Appetite suppressants have been linked to the onset of primary pulmonary hypertension. One drug that has been linked to PPH is no longer on the market but according to medical experts patients who have taken the drug may not have symptoms for several years after the drug has been discontinued. Patients who are trying to lose weight should be very careful to use appetite suppressants that have been proven to be safe. Being overweight can aggravate PPH since extra pounds put more strain on the heart and the blood vessels. Healthy weight loss for those who have the disease should be done slowly by changing lifestyle habits to include eating healthy and moderate exercise. Exercise should only been done under the advice of a physician because patients with PPH have a problem with shortness of breath.
Some of the tests involved with diagnosing PPH usually include electrocardiogram, echocardiogram, chest x-ray, and cardiac catheterization. An electrocardiogram will show the size of the heart to see if it is enlarged. An echocardiogram is an ultrasound of the heart that will show the right ventricle and pulmonary arteries in order to see enlargement and estimate the pressure in the arteries. Primary pulmonary hypertension will show up in a cardiac catheterization because the procedure will measure the pressure on the right side of the heart as well as the blood vessels in the lungs.
Symptoms that should not be ignored with PPH include coughing up blood, breathing faster, racing pulse, not being able to do any activity without shortness of breath, and extreme fatigue. Pulmonary hypertension symptoms normally progress and worsen over time. When this happens it is extremely important that the patient lets a physician know. A physical examination that can reveal a problem with PPH is when there are distended veins in the neck, swelling of the ankles, legs, and hands, and an enlarged liver. When a physician is trying to make a diagnosis he or she will often do it by checking for other conditions simply because the symptoms can mimic other diseases.