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Pulmonary hypertension

Pulmonary hypertension (PH) is a medical condition characterized by high blood pressure in the arteries of the lungs (pulmonary arteries). This condition occurs when the blood vessels in the lungs narrow, become stiff, or are obstructed, which makes it harder for blood to flow through them. As a result, the heart has to work harder to pump blood through the narrowed vessels, leading to increased pressure in the pulmonary arteries.

Pulmonary hypertension can be classified into five groups based on the underlying causes and mechanisms:

  1. Group 1: Pulmonary Arterial Hypertension (PAH): This is a primary form of pulmonary hypertension where the exact cause is often unknown. It can also be associated with various underlying conditions such as connective tissue diseases, genetic mutations, and certain drugs.
  2. Group 2: Pulmonary Hypertension due to Left Heart Disease: This type of pulmonary hypertension is caused by left heart conditions such as heart failure, valvular heart diseases, and cardiomyopathies, which can lead to elevated pressure in the pulmonary arteries due to backing up of blood from the left side of the heart.
  3. Group 3: Pulmonary Hypertension due to Lung Diseases and Hypoxia: Lung diseases such as chronic obstructive pulmonary disease (COPD), interstitial lung disease, and sleep apnea can cause pulmonary hypertension by affecting the lung tissue and blood vessels.
  4. Group 4: Chronic Thromboembolic Pulmonary Hypertension (CTEPH): CTEPH results from chronic blood clots forming in the pulmonary arteries, leading to narrowed or blocked blood vessels. It is a rare but serious complication of acute pulmonary embolism.
  5. Group 5: Miscellaneous Causes: This group includes various other conditions that can lead to pulmonary hypertension, such as blood disorders, metabolic disorders, and certain medical conditions.

Symptoms of pulmonary hypertension can vary depending on the severity and the underlying cause, but they often include:

  • Shortness of breath, especially during physical activity
  • Fatigue
  • Chest pain or discomfort
  • Rapid heartbeat
  • Dizziness or fainting
  • Swelling in the ankles, legs, and abdomen

Diagnosis typically involves a combination of medical history review, physical examination, imaging tests (such as echocardiography and right heart catheterization), and possibly blood tests to evaluate the function of the heart and lungs.

Treatment approaches vary based on the underlying cause and the severity of the condition. They can include medications to relax and widen the pulmonary arteries, reduce fluid retention, improve heart function, and address underlying causes. In some cases, surgical interventions such as lung transplantation or pulmonary thromboendarterectomy may be necessary.

It’s important for individuals with pulmonary hypertension to work closely with their healthcare providers to manage their condition, as early diagnosis and appropriate management can improve quality of life and outcomes. Visit Dr. Gayathri Ganapathy is an expert in Asthma, Allergy diseases, Chronic obstructive pulmonary diseases, Management of Chronic cough, Snoring and sleep disorders, Acute and chronic bronchitis, Pleural diseases, Pulmonary  infections, Pulmonary rehabilitation services with non invasive ventilation and long term oxygen therapy, and Management of Lung nodules and lung cancer.

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