Pulmonary hypertension, also known as pulmonary embolism is referred to the blood clot in one of the pulmonary arteries in the lungs. It occurs when a clot from another part of the body (mostly legs or arms) moves through the bloodstream and gets lodged in the lung. As the clot results in the blockage of blood flow to the lungs, this can be life-threatening. Though, immediate treatment can be highly effective in reducing the risk of death. Blood clot formation can be prevented by taking appropriate measures that will help to protect against pulmonary embolism.

Symptoms of pulmonary hypertension

The symptoms are very slow onset and can be confused with other medical conditions. It usually leads to delayed diagnosis.

  • Gradual onset of Shortness of breath
  • Fatigue
  • Chest pain
  • Dizziness or passing out
  • Leg swelling
  • Raynaud’s phenomenon (Fingers and toes turning blue in cold)

Causes of pulmonary hypertension

Pulmonary Hypertension has been divided into several types based on similarity in their pathophysiology (causation of disease) and response to treatment. It is important to accurately classify pulmonary hypertension to ensure accurate treatment.

  • Group I (Pulmonary Arterial Hypertension): Idiopathic, Familial, HIV, Scleroderma, drugs, toxins, Congenital heart disease, Sickle cell disease
  • Group II (Pulmonary Venous Hypertension): Pulmonary venous hypertension due to left-sided heart disease.
  • Group III (Hypoxia): COPD, Interstitial lung disease, Sleep apnea
  • Group IV (Embolic): Chronic thromboembolic disease (Blood clot in the lungs)
  • Group V (Miscellaneous): Sarcoidosis, Compression of the pulmonary artery by tumor

How pulmonary hypertension is diagnosed?

Initially, diagnosis is suspected based on symptoms of shortness of breath, chest pain, and leg swelling. Several tests are done to confirm the diagnosis and cause of pulmonary hypertension.

  • Echocardiogram: it is a simple and non-invasive test. It is an excellent screening test and gives an estimate of Pulmonary artery pressures.
  • Right heart Catheterization: In this test, a tube is inserted via the groin, neck, or arm to measure pressures in the right side of the heart and pulmonary artery.
  • Chest X-ray, Pulmonary function test: To rule out COPD
  •  Sleep Study: To rule out sleep apnea
  •  CT scan of the lungs: To rule out blood clots in the lungs.
  •  Blood tests: For evaluation of rheumatic diseases like lupus, RA, Scleroderma
  • Ultrasound
  • Pulmonary angiogram

Pulmonary hypertension treatments

The treatment will depend on the type of pulmonary Hypertension.  Treatment is often aimed at:

  • Lifestyle modifications: Reduce salt intake, increase physical activity, limit alcohol, quit smoking
  • Treating the underlying cause like COPD
  • Specific Medications to lower Pressure in the lungs (Vasodilator therapy for Pulmonary Hypertension)
  • Clot dissolvers
  • Blood thinners
  • Water Pills to help with symptoms
  • Surgery like a lung transplant, clot removal, or vein filter may be needed in specific cases.
  • Oxygen may be needed for the majority of the cases.