Pulmonary Hypertension

Topic Overview

What is pulmonary hypertension?

Pulmonary hypertension is high blood pressure in the arteries of your lungs. This may also be called pulmonary arterial hypertension (PAH).

These arteries carry blood from the heart to the lungs, where the blood picks up oxygen. The walls of the arteries may get thick, which narrows the space inside the arteries. When this happens, blood does not flow as well as it should. Pressure builds up in the arteries. Then your heart has to work harder to pump blood through your lungs.

Pulmonary hypertension may cause heart failure. Heart failure means that your heart doesn't pump as much blood as your body needs.

It can be stressful to learn that you have a problem with your lungs and heart. But there are things you can do to feel better and stay as active as you can.

What are the symptoms?

At first, you may not notice any problems. But in time, you may have symptoms such as:

• Shortness of breath.
• Feeling tired, faint, or dizzy.
• Swelling (edema) in your legs, ankles, feet, and belly.
• Chest pain.

What causes this condition?

There are several types of pulmonary hypertension with different causes. For example, it may be caused by:

• Another disease. Many conditions can lead to pulmonary hypertension, including:
  • Heart disease, such as heart failure, a heart valve problem, or a congenital heart defect.
  • Chronic lung disease, such as COPD or pulmonary fibrosis.
  • Blood clots in the lungs.
  • Connective tissue disease, such as scleroderma, lupus, or rheumatoid arthritis.
  • Sickle cell disease.
• Certain drugs or toxins.
• Inherited gene changes.
• Unknown causes. This is called idiopathic pulmonary hypertension.

How is it diagnosed?

It can be hard to diagnose pulmonary hypertension, because many other conditions can cause the same symptoms. If your doctor thinks you have it, you may have tests such as:

• A chest X-ray.
• Lung function tests.
• An echocardiogram, which is an ultrasound test of the heart.
• A CT scan of the lungs.

You may also have a cardiac catheterization. This test can check the blood pressure in the lung arteries. For this test, a doctor inserts a thin, flexible tube called a catheter into the heart through a blood vessel.

Your doctor may do other tests to look for what's causing the high blood pressure in your lungs.

How is it treated?

Treatment can help you feel better and live longer. It may take some time to find the treatments that work best for you.

Your treatment options will depend on the type of pulmonary hypertension you have and how severe it is. If the cause was found, your doctor will give you treatment for that condition. You may be given special medicines to treat the high blood pressure in your lungs. These medicines work in different ways to help ease your heart's workload.

Other treatments that may be prescribed include:

• A diuretic to reduce fluid buildup.
• A blood thinner to help prevent blood clots.
• Oxygen therapy to make breathing easier.

Your doctor may suggest pulmonary rehab. This is a program that provides education and support for people with lung disease. It can teach you ways to do your daily activities that save your energy as much as possible. It can also connect you with people who can help as you adjust to this disease.

Surgery, such as a heart or lung transplant, may be an option for some people.

What can you do at home?

Pulmonary hypertension may be hard to live with. But with time and patience, you can learn to cope with this condition. Taking an active role in your treatment can help you feel better and live the life you want.

Make the most of your energy

• Be as active as you can. Talk to your doctor before you start a new activity. Your doctor can help you choose a safe type and level of activity. Even if you can only do a small amount, exercise will help you get stronger and have more energy.
• Learn ways to save your energy. For example, arrange your home so things you use often are in easy reach. Put a stool in your shower so that you can sit down. Rest when you need to.
• Get help with daily activities. Friends or family members may be able to help with chores that are tiring or hard for you. Find out if your grocery store and drugstore will deliver.

Stay as healthy as you can

• Try to avoid colds and flu.
  • Get a pneumococcal vaccine shot. If you have had one before, ask your doctor if you need another dose.
  • Get the flu vaccine every year.
  • If you must be around people with colds or flu, wash your hands often.
• Eat healthy foods, and try to stay at a healthy weight. Healthy foods can help you have the energy you need.
• Do not smoke. Smoking can make this condition worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

Manage your medicines

• Take your medicines exactly as prescribed. Be safe with medicines. Do not stop or change your medicines without talking to your doctor first. Talk to your doctor if you have problems with your medicines.
• If you take a blood thinner, be sure to get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.
• Talk to your doctor before you take any over-the-counter medicines, vitamins, or herbal products. Do not take ibuprofen (Advil or Motrin) or naproxen (Aleve) without talking to your doctor first.

Cope with your emotions

Having this disease can be stressful. You may feel depressed that you can't do some of the things you used to do. You may worry about your future. And symptoms such as shortness of breath can make this anxiety worse. It may help to:

• Get emotional support from friends and family. Or you might think about joining a support group.
• Learn ways to relax and manage stress, such as yoga or meditation.
• Talk to your doctor if you feel sad and hopeless much of the time or if you are worried and anxious. These may be signs of depression or anxiety. Treatment with counseling and medicine can help.

Don't get pregnant

If you're a woman of childbearing age, talk to your doctor about preventing pregnancy. Pregnancy and childbirth can cause changes in the body that could be life-threatening for women who have this condition.