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Pulmonary Hypertension

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Pulmonary Hypertension Definition

High blood pressure in the pulmonary artery that conveys blood from the right ventricle to the lungs. The pressure in the pulmonary artery is normally low compared to that in the aorta. Pulmonary hypertension can irrevocably damage the lungs and cause failure of the right ventricle.

Pulmonary hypertension is conventionally divided into primary and secondary types. Primary pulmonary hypertension is considered idiopathic (of unknown origin). It occurs sporadically with no family history of the disorder and in a familial form.

Secondary pulmonary hypertension may be due to congenital heart disease, pulmonary embolism, portal hypertension, collagen vascular disorders (such as lupus), sarcoidosis, and HIV infection.

The goals of treatment for pulmonary hypertension are to treat the underlying cause, to reduce symptoms and improve quality of life, to slow the growth of the smooth muscle cells and the development of blood clots; and to increase the supply of blood and oxygen to the heart, while reducing its workload. Treatments include medications, oxygen, and lung transplant. The main medications for pulmonary hypertension include:

  • anticoagulants (to reduce the formation of blood clots);
  • calcium channel blockers, which relax blood vessels and increase the supply of blood and oxygen to the heart, while reducing its workload;
  • continuous intravenous epoprostenol (prostacyclin currently considered the most effective therapy) which widens the lung arteries and prevents blood clot formation;
  • treprostinil, another prostacyclin, also relaxes blood vessels and increases the supply of blood to the lungs, reducing the workload of the heart;
  • bosentan, a relatively new treatment that widens the lung arteries and reduces blood pressure;
  • nitric oxide inhalation, which causes the pulmonary arteries to widen or open;
  • Viagra (sildenafil) which causes the pulmonary arteries to open; and
  • diuretics which may help ease symptoms and improve the heart's performance in some patients with pulmonary hypertension.

The term "pulmonary hypertension" is composed of "pulmonary" for lung, "hyper" for high, and "tension" for blood pressure = pulmonary high blood pressure, or pulmonary hypertension.

SOURCE:
MedTerms.com

What are pulmonary arteries?

The human body has two major sets of blood vessels that distribute blood from the heart to the body. One set pumps blood from the right heart to the lungs and the other from the left heart to the rest of the body.

  • The portion of the circulation that distributes oxygen-rich blood from the left side of the heart, throughout the body, is referred to as the systemic circulation.

  • The blood then returns from the body to the right side of the heart and passes through the lungs to replenish oxygen.

  • It then returns to the left side of the heart for another round through the systemic circulation.

  • The portion of the circulation that distributes the blood from the right side of the heart to the lungs is referred to as the pulmonary (lung) circulation.

  • The pulmonary arteries are the major blood vessels that carry blood from the right side of the heart to the lungs.

The left ventricle of the heart pumps oxygenated blood (blood that has been reloaded with oxygen in the lungs) from the lungs into the systemic circulation. When a doctor or a nurse measures the blood pressure on a person's arm, he/she is measuring the pressures in the systemic circulation. When these pressures are abnormally high, the person is diagnosed as having high blood pressure (hypertension).

What is pulmonary hypertension?

The right ventricle pumps blood returning from the body into the pulmonary arteries to the lungs to receive oxygen. The pressures in the lung arteries (pulmonary arteries) are normally significantly lower than the pressures in the systemic circulation. When pressure in the pulmonary circulation becomes abnormally elevated, it is referred to as pulmonary hypertension, pulmonary artery hypertension, or PAH.

Pulmonary hypertension results from constriction, or stiffening, of the pulmonary arteries that supply blood to the lungs. Consequently, it becomes more difficult for the heart to pump blood forward through the lungs. This stress on the heart leads to enlargement of the right heart and eventually fluid can build up in the liver and other tissues, such as the in the legs.



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