Pulmonary hypertension

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

Mechanism

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. Oxygen-saturated blood is then pumped by the left ventricle 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 lungs. In pulmonary hypertension the pulmonary arteries become hard and stiff, unable to accommodate increased blood flow to lungs. Additionally, pulmonary arteries may be partially or completely blocked by blood clots. As a consequence, 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).

Prevalence

Pulmonary hypertension is a heterogenous group of different heart and lung conditions. Pulmonary hypertension is commonly diagnosed in the 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)

    Prognosis

The prognosis of pulmonary hypertension depends on the severity of the underlying condition and available treatment options for the primary problem. Lung disease can be usually stabilised by respiratory physicians, there is a range of medical and device treatments for heart failure and valve disease can be successfully treated surgically. In case of pulmonary arterial hypertension, there are many new medicines that improve prognosis and symptoms but it remains a serious condition.

Book an appointment