Pulmonary Hypertension

Pulmonary hypertension (PH) is high blood pressure in the blood vessels in the lungs. PH can be caused by many conditions. One type is caused by an imbalance of chemicals that relax and narrow the lung vessels. This type of PH is called pulmonary arterial hypertension (PAH). PAH is not a common condition. There are medications that can be used to treat PAH. More commonly PH is caused by a problem with the heart, lungs, or blood clots in the lungs. For these types of PH, the best treatment is to manage the condition causing the PH.

PH may occur when someone has heart failure, because the blood backs up on the left side of the heart into the lung vessels and increases the pressure in the lung vessels. This type of PH can occur because of stiff or leaky heart valves, a stiff heart muscle that doesn’t relax, or a large heart that doesn’t pump well. Since this type of PH is due to back flow of blood into the lungs and not a problem in the lung vessels, treating the heart problem is the best way to manage the PH.

When the pressures in the lung vessels increase, it becomes difficult for the right side of the heart to pump blood through the lungs to the left side of the heart. Symptoms of PH include being short of breath, lightheaded or dizzy, having chest pressure, and swelling in the feet, ankles or stomach. Lower salt and fluid intake may improve symptoms, but usually a water pill to rid the body of extra fluid is needed.

Several tests are needed to spot why the pressures in the lung vessels are high. Common tests to detect PH include an echocardiogram, chest x-ray, lung perfusion scan and pulmonary function tests. To decide if PH is due to a heart problem, a special line is placed in the neck or leg vein to measure pressures in the heart and lungs and watch the heart function. Once the cause of PH is determined, treatment can begin.