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Pulmonary Hypertension Warning Signs: What To Look Out For
© Provided by Getty Images Pulmonary Hypertension image Overview
A condition in which high blood pressure affects arteries of the lungs, and right side of the heart. This results in chest pain and shortness of breath.
Symptoms
Symptoms include chest pain and shortness of breath.
Causes
Hypertension or high blood pressure, due to blocked lung arteries.
Diagnosis
Diagnosis is difficult because the symptoms are similar to those of other heart and lung conditions. Several tests are performed before confirming the condition.
→ Common treatment options
→ How is this diagnosed?
Highlights
Medications
Blood vessel dilators: Used to dilate the blood vessel so that blood pressure can be controlled.
Epoprostenol
Endothelin receptor antagonists: Prevents narrowing of blood vessels so as to maintain normal blood pressure.
Bosentan . Macitentan . Ambrisentan
Calcium channel blockers: Relax heart muscles.
Amlodipine . Diltiazem . Nifedipine
Phosphodiesterase (PDE) inhibitors: Clears the blood vessels in the lungs for easy flow of blood
Tadalafil . Sildenafil
Enzymes: Relax pulmonary artery by interacting with nitric oxide.
Riociguat
Digitalis glycosides: This drug helps the heart beat stronger and pump more blood; also controls the heart beat rate.
Digoxin
Diuretics: Helps to reduce fluid retention, thereby reducing the load on the heart to pump more blood.
Furosemide
Anticoagulants: Prevent blood clots in the pulmonary arteries. Usually recommended for rare cases.
Warfarin
→ Do you have a health question on your mind for pulmonary hypertension? Ask professionals from across the world
→ Interested to know more? Check out the full article here
Hitting Frustrating Roadblocks When My Symptoms Are Dismissed
Throughout my 18-year journey with pulmonary hypertension (PH), I've unfortunately had many experiences where doctors have brushed off my symptoms.
I was once admitted to an intensive care unit where healthcare providers dismissed my hyponatremia, or low sodium levels, assuming it was simply a side effect of my PH. Incidents like these make me feel like I've hit a roadblock in managing my complicated care.
More recently, I've been experiencing uncontrolled chest pains, confusion, and other neurological issues, which may be partially related to PH. However, a chest X-ray also showed left lobe atelectasis, which I only discovered when I checked my online patient chart the following day. I believe this should be investigated further, so now I'm awaiting another appointment. Having to advocate for myself is overwhelming and exhausting!
It's especially frustrating when healthcare professionals trivialize my concerns — particularly when my team later discovers that they were valid and something serious was going on. New symptoms are often blamed on my PH and chronic kidney disease, and thus remain unexplored. Other times, my symptoms are chalked up to vague issues like "the effects of polypharmacy" or "metabolic problems." To me, these answers indicate that a provider is uncertain about the root cause of my symptoms.
We are the best experts on our bodiesIt's upsetting when healthcare professionals disregard my persistent concerns, but I recognize I'm not alone in this struggle.
As patients, we must advocate for our health, conduct our own research, and ensure that we receive proper medical attention — whether we have PH or not. It's important that our providers conduct a thorough examination, investigate any medical issues, and work to pinpoint their cause. We all deserve that.
It's also crucial that doctors listen carefully to patients, as our description of our health concerns can provide valuable insights. In my experience, it helps to gather information about diet, exercise, lifestyle, current treatments, and other underlying conditions. These data can help uncover potential causes, leading to accurate diagnoses and improved treatment plans.
Grateful for healthcare providers who listenI want to note that many of my healthcare providers listen to my concerns with open ears and offer support. I appreciate my empathetic team.
The difficulties tend to arise during ER visits or encounters with new doctors. Explaining my medical history and suggesting treatment options to a new provider, especially for issues unrelated to PH, can be tiresome. When a doctor refuses to delve deeper or collaborate with my other providers, it makes me uneasy. I often leave these appointments feeling judged, as if my concerns make me an addict, a hypochondriac, or irrational. Can any of you relate?
Still, I remain optimistic that dedicated, compassionate professionals outweigh the rest.
We all deserve validation and respectI know my experience isn't unique, as I've heard many others share similar accounts of dismissal or inadequate care. Advocating for myself can be challenging, particularly when I'm grappling with chronic illness and not feeling well. I yearn to have all my concerns addressed, rather than being made to feel that my medical needs are insignificant.
Managing a rare, chronic disease often brings roadblocks like these. I share my experiences to support others and to advocate for future patients. I don't intend to criticize healthcare providers; they've undoubtedly saved my life several times.
I didn't choose to have a rare disease, and I don't take pleasure in consulting many specialists to manage my well-being. Regrettably, this is my predicament, but I strive to flourish nonetheless. It's the least I deserve.
Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.
What To Know About Portopulmonary Hypertension
Portopulmonary hypertension is increased arterial pressure in the vessels of the lungs and the vein that delivers blood to the liver.
Portopulmonary hypertension involves high blood pressure in the arteries in the lungs and the portal vein. The portal vein delivers blood from the intestines to the liver.
High blood pressure can develop separately in the lungs and portal vein. Doctors diagnose portopulmonary hypertension when both types of high blood pressure happen together.
Experts do not know exactly how many people live with this type of hypertension. Estimates suggest it accounts for anywhere from 5–15% of cases of high blood pressure in the lungs. It also affects about 5–6% of people with advanced liver disease.
This article covers the symptoms, causes, and treatments of portopulmonary hypertension.
Before understanding portopulmonary hypertension, it may be helpful to learn a bit about pulmonary hypertension and portal hypertension.
Pulmonary hypertensionDamage, scarring, or narrowing of the vessels in the lungs can cause an increase in blood pressure in the vessels of the lungs.
This type of high blood pressure is uncommon. Only about 500–1,000 people receive a pulmonary hypertension diagnosis in the United States each year.
Common causes of high blood pressure in the lungs include:
Portal hypertensionPortal hypertension involves high blood pressure in the portal venous system. The portal venous system delivers blood to the liver.
The most common cause of this type of high blood pressure is liver cirrhosis, also known as advanced liver disease.
Additional causes of portal hypertension include:
Doctors categorize the condition as portopulmonary hypertension when a person has high blood pressure in the portal vein and arteries of the lungs.
Portopulmonary hypertension tends to have a worse outlook and survival rate than pulmonary hypertension.
According to a 2020 review, a poor outlook may be more likely when a person has liver disease and portopulmonary hypertension.
Symptoms of portopulmonary hypertension are similar to the symptoms of pulmonary hypertension.
However, since it often develops due to liver disease, a person may also experience other symptoms, such as:
Portopulmonary hypertension often develops due to cirrhosis.
Over time, structural changes in the liver can cause alterations in the veins that may lead to problems with blood flow. This increases blood pressure in the portal veins, causing portal hypertension.
When portal hypertension develops, it also affects other areas of the body.
For example, the heart has to work harder, which may affect the vessels in the lungs, leading to portopulmonary hypertension.
In addition to advanced liver disease, the condition can also develop due to:
Factors that increase the risk of liver disease also increase the chances of developing portopulmonary hypertension. They include:
Doctors diagnose portopulmonary hypertension on the basis of a physical exam, symptom review, and diagnostic tests.
During a physical exam, doctors look for signs of leg swelling, heart murmur, and jugular vein distension (bulging of the major veins in the neck).
About 40 in 100 people with portopulmonary hypertension have a tricuspid valve murmur.
The standard diagnostic test to confirm a diagnosis of portopulmonary hypertension is a procedure known as right heart catheterization.
Diagnosis of portal hypertensionTo diagnose portal hypertension, doctors assess the clinical features of the condition using abdominal ultrasound and CT scans, including:
Treatment of portopulmonary hypertension remains similar to treating general pulmonary hypertension. The goal of treatment is to lower blood pressure in the arteries of the lungs.
Usually, treatment involves medications known as vasodilators to widen the blood vessels, which decreases blood pressure in the arteries.
Liver transplantation can help improve the condition. However, having portopulmonary hypertension may exclude a person from getting a liver transplant.
Portopulmonary hypertension is increased blood pressure in the portal veins that deliver blood to the liver and the pulmonary arteries in the lungs.
It typically develops due to severe liver disease.
Symptoms of portopulmonary hypertension include fatigue, chest pain, and shortness of breath, especially with activity.
Treatment involves medication that can help reduce pressure in the blood vessels.
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