Pulmonary hypertension

Pulmonary hypertension (PH) is a condition with abnormally elevated blood pressure in the pulmonary arteries - the vessels carrying blood from the right side of the heart to the lungs. Depending on the severity, it can be a serious condition where the increased strain on the right-sided heart chambers may ultimately lead to heart failure. People with pulmonary hypertension may have symptoms including tiredness, breathlessness, chest discomfort, dizziness, palpitations and blackouts.


The blood poor in oxygen is pumped by the right ventricle (one of the bottom heart chambers) to the lungs, where it is enriched with oxygen. The left ventricle pumps oxygen-saturated blood to the whole body, and oxygen is used up in muscles and organs.

Under normal circumstances, the demand for oxygen increases during physical exertion, therefore heart rate goes up, and pulmonary arteries widen up to allow better blood supply to the lungs. In pulmonary hypertension, the pulmonary arteries become hard and stiff, unable to accommodate increased blood flow to the lungs. Additionally, pulmonary arteries may be partially or completely blocked by blood clots. Consequently, the right ventricle has to work harder to push blood through the narrowed pulmonary arteries, which may gradually lead to enlargement and weakening of the heart (heart failure) and heart rhythm problems (arrhythmias).


Pulmonary hypertension is a heterogeneous group of different heart and lung conditions. Pulmonary hypertension is commonly diagnosed in patients with:

  • Chronic obstructive pulmonary disease (COPD)
  • Heart failure due to myocardial infarction (heart attack) or dilated cardiomyopathy (disease of the heart muscle without involvement of coronary arteries)
  • Valve disease, most commonly mitral stenosis, mitral regurgitation and tricuspid regurgitation
  • Pulmonary arterial hypertension (PAH), previously called primary pulmonary hypertension (no other underlying condition, more frequent in women)


The prognosis of pulmonary hypertension depends on the severity of the underlying condition and available treatment options for the primary problem. Respiratory physicians can usually stabilise lung disease. There is a range of medical and device treatments for heart failure, and valve disease can be successfully treated surgically. Many new medicines improve prognosis and symptoms in pulmonary arterial hypertension, but it remains a serious condition.

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