TriStar Medical Group - December 07, 2020

Pulmonary issues—or issues involving breathing and lung function—are among the most common conditions driving patients to seek care across our healthcare system. Pulmonary hypertension, though considered a relatively rare disease, is one such condition that we treat frequently.

What is pulmonary hypertension?

Pulmonary hypertension occurs when high blood pressure in the lung and heart arteries impacts the delivery of fresh blood to your heart and the return of blood back into your lungs. Typically, clinical experts break the causes of pulmonary hypertension into five groups, similar to the American Heart Association (AHA):

  1. Group 1 - Pulmonary arterial hypertension (PAH). In some cases, the cause of PAH may be unknown. PAH can be inherited from a family member or stem from pre-existing heart issues at birth. Excessive use of drugs and toxins can also cause PAH, as well as certain conditions like connective tissue disorders, HIV infection or chronic liver disease.
  2. Group 2 - Pulmonary hypertension caused by left-sided heart disease. Group 2 most likely has experienced a failure in the lower left chamber of their heart or a left-sided heart valve disease. This is the most common cause of pulmonary hypertension.
  3. Group 3 - Pulmonary hypertension initiated by lung disease. This is usually related to lung complications like COPD or scarring in the tissue between the lungs' air sacs (pulmonary fibrosis). Other causes include sleep apnea or extensive exposure to high altitudes for at-risk patients.
  4. Group 4 - Pulmonary hypertension triggered by chronic blood clots. General clotting disorder or blood clots in the lungs are the leading causes for this group.
  5. Group 5 - Pulmonary hypertension activated by other health disorders. These health conditions can include blood disorder, systemic disorder, metabolic disorder, and kidney disease or tumors pressing on pulmonary arteries.

Symptoms of pulmonary hypertension

Pulmonary hypertension symptoms can develop slowly, go unnoticed for an extensive period of time, and be misinterpreted as asthma or chronic obstructive pulmonary disease (COPD). These factors make it challenging to diagnose and require a consultation with a specialist. Susan Garwood, HCA Healthcare Physician Director of Pulmonary Disease, further explains by stating "The varied etiologies and complex management strategies required to appropriately diagnose and treat this condition should be handled by a pulmonary hypertension specialist for optimal outcomes. Often patient symptoms are left unrecognized, resulting in a prolonged delay in treatment and severe consequences to your cardiopulmonary morbidity and mortality."

Moreover, there are common signs to be on the lookout for if you or a loved one may have this disease:

  • Chest pain
  • Fainting or light-headedness
  • Fatigue
  • Heart racing or palpitations
  • Loss of appetite
  • Shortness of breath
  • Swelling

Treatment and lifestyle changes

Currently, there is not a cure for pulmonary hypertension, but it shouldn't stop you from living a vigorous and fulfilling life. The AHA recommends these simple lifestyle changes to support your health:

  • Air travel and high-altitudes need to be proceeded with caution, and you may need to bring extra oxygen.
  • Avoid long baths, hot tubs or saunas.
  • Maintain a proper balance of fruits, vegetables, lean meat and whole grains in your meal plan.
  • Record your weight daily to be aware of any unexpected changes.
  • Stay active and walk often, while avoiding overly strenuous lifting.
  • If you smoke, quit. Speak with your doctor about recommended programs.

Consult with your doctor before ingesting any over-the-counter drug, as they could worsen symptoms or obstruct prescribed remedies, like medication to reduce swollen feet. Your doctor may also recommend a medicine that can be given through the veins and oxygen therapy for patients with deficiencies.