Pulmonary Hypertension - Treatments

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What is the treatment for pulmonary hypertension?

The treatment for pulmonary hypertension depends on the underlying cause.

  • If left sided heart failure is the primary problem, then adequate treatment of the left heart failure by a cardiologist is the main stray of treatment.
  • In cases where hypoxia (low oxygen levels) due to any chronic lung disease, such as COPD, is the cause, then providing oxygen and appropriately treating the underlying lung disease by a lung doctor (pulmonologist) is the first step in treatment.
  • In some patients, the elevated pressure may be related to obstructive sleep apnea syndrome (OSAS), and can be reduced with the use of a CPAP, (a device that delivers positive airway pressure during sleep).
  • In conditions, such as scleroderma, which often can cause pulmonary hypertension, a rheumatologist is involved in the treatment program.
  • Anticoagulation (thinning the blood) may be a treatment option if the main underlying cause is thought to be recurrent blood clot (chronic thromboembolic pulmonary hypertension). As indicated in previous section, referral to a specialty center may be warranted for a possible surgical removal of blood clot (thromboendarterectomy).
  • For patients with primary pulmonary hypertension (those with no underlying cause), more advanced therapy may be attempted. These drugs have complex mechanisms, but in general they work by dilating (opening up) the pulmonary arteries and, therefore, by reducing the pressure in these blood vessels and some help prevent the excessive overgrowth of tissue in the blood vessels (that decrease remodeling of the vessels, as described previously). Besides constriction, PAH can result in an actual structural change of the pulmonary arteries, whether it is due to chronically elevated pressures or the disease itself, or a combination of the two is not completely clear. These drugs also can delay and in some cases reduce the degree of remodeling of the pulmonary arteries.
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See what others are saying

Comment from: ros85, 25-34 Female (Patient) Published: July 31

I have been diagnosed with pulmonary hypertension (PH) for just over 3 years. The only reason I found out I had PH was because of a tiny stroke I had in November 2010 (which was caused by a birth control I was on, NuvaRing). When I went to the emergency room (ER) the doctor on call said he didn't think it was a stroke and said it was migraines because of my age (26). We asked for a referral to the neurologist and waited 3.5 months to see him. Within a week I was sent for an echo and Holter monitor. From the echo the doctor knew exactly what I had and sent me the next day to the PH clinic where I was properly diagnosed. I do have daily struggles and good and bad days. I try to research as much as I can and get different kinds of feedback. I hold a full time job and a part time job, but take advice where it is offered. I rest as much as I can and look positively at life.

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Comment from: Lizzie, 65-74 Female (Patient) Published: June 19

After years of suffering worsening shortness of breath and weakness in my legs, and many visits to various specialists, my general physician sent me to a cardiologist she said would put me through a lot of tests, if I was willing. I was. After a number of scans, respiratory and sleep tests and echocardiograms, then finally a right heart catheter, I was diagnosed with severe pulmonary hypertension. Bosentan was prescribed and made a difference, but after only 3 months my liver function blood tests were bad so a change of medication to ambrisentan was made. I also had 2 cardiac stents inserted in arteries that were heading to blockage, and then 18 months later, a pacemaker for sick sinus syndrome. I am better than I've been for years. I am an Australian and lucky to receive all medication for a fraction of the normal cost. Various other medications have been prescribed during the last couple of years, but along with the ambrisentan, I am now on only cholesterol and blood pressure lowering medications and aspirin. Being physically active and walking keep me feeling good.

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