Pumonary Hypertension

PH

pathophysiology

  • increased pressure of the pulmonary arteries

  • carry blood away from the R ventricle of the heart to the lungs for oxygen

  • starts with inflammation

  • the walls of the arteries begin to tighten,

  • the walls of the arteries are stiff at birth or become stiff from overgrown cells

  • blood clots form in the arteries.

  • These changes make it difficult for the heart to push blood through the pulmonary arteries and make it to the lungs

  • the pressure rises, and the heart becomes exhausted from making the right ventricle work twice as hard

  • most likely result in heart failure, death.

Etiology

Idiopathic pulmonary hypertension (IPH)

When an underling reason cannot be found, it is called Idiopathic pulmonary hypertension. Some people with IPH may carry a gene that may make them more at risk for developing IPH.

Secondary pulmonary hypertension is caused by other medical problems. This type of pulmonary hypertension is more common than IPH.

Reasons that secondary pulmonary hypertension may develop ;

  • blood clots in the lungs (pulmonary embolism)
  • chronic obstructive pulmonary disease like Emphysema
  • connective tissue disorders such as Lupus or Scleroderma
  • congenital heart defects
  • Sickle Cell anemia,
  • chronic liver disease, AIDS,
  • pulmonary fibrosis because of scarring and certain stimulant drugs such as cocaine.
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Risk factors

  • Women of a childbearing age should try to avoid becoming pregnant. The mother and child's life would be in great risk and danger because of the internal changes and the amount of blood flow the baby relies on the mother for.
  • Birth control pills could form blood clots as well so they should also be avoided. They should speak to their doctor about a tubal ligation or an IUD to avoid the possibility of becoming pregnant.
  • Avoid traveling to or living at high altitudes. High altitudes can worsen the symptoms of pulmonary hypertension because it is harder to breathe.
  • Avoid the opposite effect and lowering their blood pressure, such as sitting in a sauna or hot bath and or shower.
  • Should not over exert themselves by lifting weights or pushing something heavy.
  • Try to live a stress free life ; may try something that could calm ones mental state such as meditation, prayer, or sitting.
  • A nutritious diet and healthy weight should be reached.
  • Note** It's likely the physician will recommend limiting the amount of salt intake order to minimize swelling of the body's tissues (edema).
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Prevention

Unfortunately, there is not a definite way to avoid (PH) but some helpful measures that a person can do in order to decrease the effects of pulmonary hypertension, are as follows; For IPH, genetic testing would be a preventive test that could be done to see if the person is a gene carrier for the disorder.

Also, getting an ECG as soon as possible, getting plenty of rest because resting can reduce the exhaustion that may come from having pulmonary hypertension. Get active and stay active! A calm level of activity or exercise such as walking may be beneficial because the heart and lungs are working, of course using oxygen during exercise may be especially helpful if needed. The doctor can help plan an appropriate exercise program for that individual. Another life style change that would be greatly beneficial is smoking cessation , also avoid inhalation of second hand smoke .

Therapeutic Interventions

  • Vasodilator
  • Steroids
  • Calcium channel blockers
  • Blood Thinners ( reduce chances of blood clots)
  • Atrial Septostomy for severe PH, when all other therapies have been done but unsuccessful. Mortality rate is high, and is considered palliative.
  • A lung or heart transplantation would be beneficial if all other treatments and or therapies fail.
  • In other forms of pulmonary hypertension, a bilateral lung transplant is often the direction that is chosen.
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New Research

August 2015

Physical Therapist researcher (Indianapolis)

Tested a lab rat in the beginning stages of PH, the rat performed short periods of intrinsic workouts. This caused the PH to decrease at resting and exercise state, also a decrease in the size of the right side ventricle. It is believed that hemodynamics needs to now be the focus in order to develop a exercise protocol that is safe and beneficial for PH patients.


April 11, 2016

  • Assessment of Thyroid Function in Idiopathic Pulmonary Hypertension
  • (PubMed) Idiopathic pulmonary hypertension (IPAH) is a rare, debilitating, and fatal disease. Late-onset treatment can lead to right heart failure, multiple organ damage, and death. Since the thyroid plays a major role in the metabolism and hemodynamics in humans, the screening of thyroid function is crucial. Thyroid dysfunction has been reported to cause pulmonary hypertension, but the thyroid is also involved in IPAH.