Pulmonary arterial hypertension is a progressive lung disorder characterized by increased pressure in pulmonary artery and lung vasculature. It leads to right sided heart failure and eventually death. Pulmonary arterial hypertension occurs when the arteries that carry blood from right side of heart (called pulmonary arteries) to the lungs become narrow and blocked.
Due to the narrowing of the pulmonary artery, it becomes difficult for the blood to flow easily through the vessel into the lungs. As a result pressure in the artery rises far more than normal level. The abnormal high pressure in the artery makes the right ventricle of heart work harder to pump the blood through the lungs. Gradually the muscles of heart become weak and fail to pump enough blood to the lungs. Patient ultimately develops right heart failure.
Causes Of Pulmonary Arterial Hypertension
Pulmonary arterial hypertension can occur in all individuals and at any age. But it is more commonly seen in young adults and in women of child bearing age.
Researchers believe narrowing occurs due to some type of injury to the lining of the pulmonary blood vessel. There is no known reason for the injury. Below are given causes and risk factors for development of pulmonary arterial hypertension:
- Age: This condition is more common in young adults and women.
- Family history: In small number of cases the disease is found to be inherited. Genetic involvement is noted for overgrowth of cellular lining of small blood vessels of lung making them narrow.
Pulmonary arterial hypertension can also occur due to other medical problems. It is known as secondary pulmonary arterial hypertension.
- Chronic diseases of lung such as emphysema and pulmonary fibrosis.
- Cirrhosis of liver.
- Connective tissue disease (most commonly systemic sclerosis and lupus).
- Heart diseases such as aortic valve disease, mitral valve disease, and other congenital heart defects.
- Sleep disorders such as sleep apnea.
- Thromboembolism: A blood clot in the pulmonary artery can cause pulmonary hypertension.
- Living at high altitude where oxygen is very less in the atmosphere.
- Intravenous abuse of certain drugs such as cocaine etc.
- Sickle cell anemia.
Symptoms Of Pulmonary Arterial Hypertension
The symptoms of pulmonary arterial hypertension are noticed only when the disease has significantly progressed. This often results in delay of diagnosis and treatment.
The first symptom of pulmonary arterial hypertension is usually shortness of breath. Patient experiences breathing difficulty on slightest physical exertion. For example while climbing stairs or walking fast for a short distance. Easy fatigue, dizziness, and pain in front side of chest are other early signs of this condition.
As the disease progresses patient may develop more serious symptoms such as blood in sputum, swelling in legs and other dependent body parts, blue discoloration of lips and nail bed, intense tiredness, and difficulty in breathing even while patient is resting. Breathlessness at rest and blue discoloration on lips are signs of worsening of the disease.
Treatment Guidelines For Pulmonary Arterial Hypertension
Since pulmonary arterial hypertension is caused by many diseases, the doctor takes detailed medial history of the patient. After clinical examination he will suggest various tests to clinch the correct diagnosis of pulmonary arterial hypertension. Doppler echo-cardiogram, chest x-ray, pulmonary function test, right heart catheterization, chest CT, etc are some of the important tests that help to diagnose the condition.
Pulmonary arterial hypertension is gradual and progressive disease which if detected in its early stage can improve the life expectancy of the patient. However, in majority of cases the condition is only found when it has advanced and caused irreversible damage to the pulmonary artery.
If the primary cause is detected for example aortic valve disease, surgical repair of the condition can reduce the risk of further deterioration of the condition. Palliative treatment consists of oxygen therapy, diuretics, potassium supplements, digoxin etc help to alleviate symptoms.
Aside from the main treatment, dietary and lifestyle changes can over all help in management of symptoms of pulmonary arterial hypertension. Patient should follow these steps if he is suffering from this condition.
- Eat foods that are high in potassium, magnesium and vitamins such as banana, green peas, strawberries etc.
- Obese people should reduce their weight.
- Reduce intake of salt.
- Avoid strenuous activities.
- Quit alcohol and smoking.