Pulmonary hypertension, also known as cardiomyopathy, is when the small blood vessels within the lungs get thickened, inflamed, constricted or otherwise damaged. Pulmonary hypertension is a form of high blood pressure, which affects your arteries, mainly the right ventricle and your pulmonary arteries. In one form of pulmonary hypertension (PAH), also known as concentric arterial hypertension (CAT), blood vessels within the pulmonary arteries are narrowed, partially blocked or completely destroyed. In other forms of pulmonary hypertension (CAH), the blood vessels within your pulmonary arteries become dilated. This is known as “cushioning”.
There are several risk factors for developing pulmonary hypertension. These include being older than 50 years, being overweight, having prolonged delays in completing the development of the lungs, having long periods of smoking, having a family history of pulmonary hypertension and having low levels of energy, oxygen and carbon monoxide in the blood. The disease can also be developed due to other causes such as tuberculosis, asthma, COPD, heart failure, previous heart attacks, obesity and sitting for extended periods of time. Pulmonary hypertension generally develops when the volume of the person’s airflow is lower than the oxygen level in the blood.
A major form of the disease is called Group 5 Pulmonary Hypertension (G5P). It is usually hereditary, although there are many geneticists who believe otherwise. G5P is likely an inherited disorder in which the walls of the left ventricle thicken and its cusps become enlarged. As a result of this enlargement and thickening of the left ventricle, the heart cannot pump blood sufficiently to supply oxygenated blood to the lungs. A high blood pressure develops with continued exposure to G5P.
Two other types of pulmonary hypertension are severe and mild. Severe pulmonary arterial hypertension of the pulmonary artery is characterised by a high blood pressure within the pulmonary artery, which develops either alone or in combination with symptoms like cough, shortness of breath, chest pain, nausea and vomiting and even fatigue. On the other hand, mild pulmonary artery hypertension or the presence of only one pulmonary artery swollen with excessive fluid results in the condition known as primary pulmonary hypertension. This usually develops on its own after long periods of exposure to high blood pressure.
In case of pulmonary hypertension of the pulmonary artery, treatment is required to reduce the high blood pressure. Treatment is usually based on identifying the cause of the condition. Treatment may focus on lowering the blood pressure and relieving the symptoms. If left untreated, severe complications of pulmonary hypertension may develop, resulting in cardiomyopathy, heart disease and sudden death. Treatment includes medication and rest. Patients are advised to avoid smoking and those with cardiomyopathy are advised to refrain from smoking.
The symptoms of pulmonary hypertension include coughing and wheezing, chest pain and swelling around the chest, breathlessness and fatigue. Other symptoms include right sided hypotension that can be caused by left sided congestive heart failure. Right sided hypotension can cause a feeling of lightheadedness and can worsen when walking, leading to breathlessness. This symptom can also be a sign of heart failure. Left sided hypotension can cause a feeling of shortness of breath and can worsen when walking, causing breathlessness. In addition, heart failure can lead to a higher risk of right sided cardiac arrest or heart attack, which can be life threatening.
There are several causes of this condition. One of the common causes of pulmonary hypertension is chronic liver disease. Other contributing factors include chronic obstructive pulmonary diseases like bronchitis, emphysema and chronic sinusitis. Some of these diseases cause obstruction of the pulmonary tract, which can result in increased pressures in the lungs, which are then responsible for the increased blood pressures. Other causes include congenital heart defects, growth hormone deficiency, diabetes, hyperlipidemia and viral infections.
When there is increased pressure in the pulmonary hypertension, the result is decreased blood flow to the lungs and increased pumping effect on the veins. Because of this, pressure builds up against the walls of the veins in the pulmonary artery. This in turn causes blood clots. The blood clots decrease the efficiency of the blood flow as well as the pumping effect of the veins. Blood clots are a major factor in narrowing down the arteries and make the airways narrow up, causing breathing difficulty and eventually the cessation of breathing.