Pulmonary hypertension

21:54 - 4 May , 2021

Disease

What is Pulmonary hypertension?

When blood pressure in the pulmonary arteries increases beyond normal limits, we are facing pulmonary hypertension, an anomaly that affects the right ventricle, causing it to grow due to the heart’s overexertion. It arises when there is a narrowing, damage, or blockage in the pulmonary blood vessels, preventing blood from flowing properly, significantly increasing the pressure in the lung arteries, and causing the heart to overwork to restore the adequate amount of blood, which causes a progressive deterioration that leads to heart failure. There are several causes for the appearance of pulmonary hypertension:
  • Genetic disorders.
  • Intake of amphetamines and methamphetamines.
  • Congenital heart conditions.
  • Diseases such as:
  • Lupus.
  • Cirrhosis.
  • HIV/AIDS.
  • EPOC.
  • Obstructive sleep apnea.
  • Pulmonary fibrosis.
  • Disorders in the mitral valve and the left ventricle.
  • Stroke.
  • Sarcoidosis.
  • Vasculitis.
  • Kidney involvement.
  • Eisenmenger's syndrome.
  • Metabolic alterations.
  • Pulmonary arteries compression due to the presence of tumors.

Symptoms

At the beginning of this condition, there are usually no symptoms, but over time the symptoms begin to appear progressively, including:
  • Dyspnea or shortness of breath.
  • Tiredness.
  • Dizziness.
  • Palpitations.
  • Chest pain or tightness.
  • Edema in legs and ankles.
  • Ascites or accumulation of fluid in the abdomen.
  • Cyanosis (blue lips and skin).
  • Loss of consciousness.

Diagnosis and treatment

Once your doctor analyzes your symptoms and clinical history, they will perform a physical examination and a series of tests that include blood tests, x-rays, electrocardiogram, cardiac ultrasound, right cardiac catheterization, computed tomography, MRI, and pulmonary function test, among others. As it is a chronic condition, it cannot be cured, so treatment focuses on controlling symptoms, slowing down its evolution, and, as far as possible, avoiding possible complications. If there is any underlying disease that is the direct cause of pulmonary hypertension, this will be treated simultaneously. The drugs used to treat this condition vary, but the most common are vasodilators, diuretics, guanylate cyclase stimulators, endothelin receptor antagonists, anticoagulants, erectile dysfunction drugs such as sildenafil and tadalafil, which help dilate the pulmonary arteries; and calcium channel blockers. When pharmacological treatment does not work, the option is a surgery called atrial septostomy, in which through a cut in the atria the pressure in the right ventricle is reduced. In extreme cases, where medications and surgery don't work, heart and lung transplants will be necessary. At the Cardiovascular Center, we offer you a wide range of prevention, diagnosis, timely treatment, and follow-up services to take care of you through a comprehensive and multidisciplinary care model. Come to us, we want to hear your heart.

Fuentes:

  • texashaert.com
  • secardiologia.es
  • mayoclinic.org
  • medlineplus.gov
  • msdmanuals.com
  • fundacionmexicanadelcorazón.org
  • medigraphic.org
  • Pulido ZT. Hipertensión arterial pulmonar primaria. Consideraciones actuales. Arch Cardiol Mex. 2001;71(Suppl: 1):142-144.
  • Vega CR. Monoterapia con sildenafilo en pacientes con hipertensión pulmonar grave. Rev Cub Med Mil. 2020;49(1):15-29.
  • Hernández-Cruz RG, Copado-Mendoza DY, Acevedo-Gallegos S, et al. Hipertensión pulmonar y síndrome de Eisenmenger en la embarazada. Serie de casos. Ginecol Obstet Mex. 2021;89(04):309-317.
  • Pérez BA, Alfonso MOA, Román FIM, et al. Síndrome de hipertensión pulmonar secundario a mixoma auricular derecho, a propósito de un caso. CorSalud. 2019;11(4):342-347.

						
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