What Is the Most Appropriate Treatment for Pulmonary Hypertension?
High blood pressure in the pulmonary arteries and the heart's right ventricle is medically referred to as pulmonary hypertension (PH).
If these blood vessels harden and narrow, less blood reaches the lungs. Consequently, you'll want a more vigorous cardiac output. The cardiac muscles become fatigued from the extra work, which might lead to heart muscle failure.
As a result of this illness, your lungs cannot provide enough oxygen to your body.
However, people suffering from pulmonary hypertension can now access several therapy options. Therefore, you should expect a decrease in the severity of symptoms if you follow your doctor's orders.
What are the symptoms?
Shortness of breath during normal activity, such as climbing stairs, is the initial sign of PH. Added symptoms consist of:-
- Tiredness
- Symptoms of fainting or dizziness
- Flushed cheeks and skin
- Pain or pressure in the chest
- Irregular and rapid heart rate
A person may not have all these symptoms, and the intensity may range. Therefore, diagnosis of PH might be challenging.
What are the leading factors that lead to pulmonary hypertension?
There are five subgroups of pulmonary hypertension based on the underlying etiology.
Group 1 - Hypertension in the arteries of the lungs (PAH). Multiple factors can lead to PAH; arteries become narrow, thick, or stiff. There is a rise in pulmonary arterial pressure due to reduced blood flow.
Group 2 - Heart failure caused by left-sided disease is because the left ventricle of the heart is responsible for distributing blood throughout the body. Problems impact the right side of the heart and the pulmonary circuit on this side of the heart. When blood pools in the heart, it pushes against the pulmonary arteries and causes them to narrow and harden.
Group 3 - Hypercapnic acidosis is caused by hypoxia or lung illness. Lung disease can induce the narrowing of the pulmonary arteries. As a result, the pressure in your pulmonary arteries rises, and less blood can go to your lungs.
Group 4 - Respiratory obstruction leading to PH. Blood clots and clot scars impede healthy blood circulation to the lungs. This raises pulmonary arterial pressure and places additional strain on the right side of the heart.
Group 5 - Secondary PH is related to other diseases. For example, blood problems and metabolic abnormalities are common comorbidities of PH. However, there isn't always agreement on the precise methods by which this disease brings on PH.
To what extent does pulmonary hypertension respond to clinical interventions?
Depending on the patient's medical history, the root of the problem, and the severity of the symptoms at the time of diagnosis, the treatment for alleviating the effects of pulmonary hypertension may take many forms. However, your doctor may recommend a different treatment plan based on your symptoms.
Doctors prescribe calcium channel blockers to lower blood pressure in the lungs and elsewhere in the body. However, blood vessel relaxation is a potential side effect of these drugs.
Vasodilators are medications used to widen blood arteries. Your doctor may recommend a vasodilator such as epoprostenol, treprostinil, oriloprost. The doctor may inject these medications directly into your veins. These medications can either be taken orally or nebulized for inhalation.
Medications called endothelin receptor antagonists to mitigate the adverse effects of endothelin, a peptide or amino acid chain made in the body. Blockage of arteries or veins may result from this material.
A higher level of nitric oxide can be achieved with guanylate cyclase stimulators. Nitric oxide helps by easing tension in blood vessel muscles. As a result, you'll notice a general lowering in your blood pressure. However, these drugs are unsafe for use while pregnant because of their adverse side effects.
Warfarin is a potent blood thinner that is also an anticoagulant. If you have pulmonary vein thrombosis, your doctor may suggest it.
Inhalational oxygen therapy is the administration of 100% oxygen. A set of prongs are placed in the patient's nose to deliver oxygen. It's suggested for those with sleep apnea or hiking to high altitudes.
Diuretics are medications that stimulate the kidneys to excrete waste products more quickly. If you do this, you'll have less of a chance of developing fluid buildup in your lungs or elsewhere in your body. Increased efficiency of the heart's muscular contractions is the result.
If a patient has tried everything else and nothing has helped, their doctor may suggest surgery as a final resort.
If medications fail to alleviate the symptoms of pulmonary hypertension, atrial septostomy may be suggested as a further course of action. Surgeons perform an atrial septostomy to release pressure on the right side of the heart by creating a hole between the upper left and the atria (right chambers of the heart). Lung transplantation is another option that may be proposed.
Measures to avoid pulmonary hypertension
Here are some things you can do to lower your risk of pulmonary hypertension:-
- Your lungs' health is at risk from smoking, so please give up the habit.
- Without your doctor's approval, you shouldn't take any additional medication.
- The dangers of high-altitude living have been well documented. Therefore, it's essential to maintain your health with frequent visits to the doctor's office.
Dr. Sarita Rao is one of the Best cardiologists in Indore and has been treating heart diseases at Apollo Hospital since many years.
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