What Is Primary Arterial Hypertension
Pulmonary arterial hypertension , formerly known as primary pulmonary hypertension, is a rare type of high blood pressure.
PAH affects the pulmonary arteries and capillaries. These blood vessels carry blood from the lower right chamber of your heart into your lungs.
As the pressure in the pulmonary blood vessels builds up, the heart must work harder to pump blood to the lungs. Over time, this weakens the heart muscle. Eventually, it can lead to heart failure and death.
Theres no cure yet for PAH, but treatment options are available. Treatment may help relieve your symptoms, lower your chance of complications, and prolong your life.
In the early stages of PAH, you might not have any noticeable symptoms. As the condition worsens, symptoms will become more noticeable. Common symptoms include:
- difficulty breathing
If your doctor suspects you might have PAH, they will likely order one or more tests to assess your pulmonary arteries and heart.
Tests for diagnosing PAH may include:
Your doctor can use these tests to check for signs of PAH as well as other potential causes of your symptoms. Theyll try to rule out other potential causes before diagnosing PAH. Get more information about this process.
Currently, theres no known cure for PAH, but treatment can ease symptoms, reduce the risk of complications, and prolong life.
Prevention Of Pulmonary Hypertension
While preventing pulmonary hypertension isnt always possible, your doctor may recommend certain treatments for health conditions that can lead to pulmonary hypertension as a prevention strategy. These health conditions range from blood clots to kidney disease to high blood pressure.
Routine screening tests for pulmonary hypertension are generally recommended only for people with known risk factors, such as scleroderma, a family history of the condition, or certain forms of lung or heart disease.
Caring For Someone With Pulmonary Hypertension
Pulmonary hypertension usually progresses slowly, and eventually results in shortness of breath and a decreased ability to perform the activities of daily living at home. For most of the course of the illness you will not need any extra assistance at home. However, at the end stage of pulmonary hypertension, you may need services such as home oxygen, council cleaning, and meals on wheels. These can be arranged through your GP or local volunteer services.
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Medical History And Physical Exam
Your doctor may ask you about any signs and symptoms you have been experiencing and any risk factors such as other medical conditions you have.
Your doctor will also perform a physical exam to look for signs that may help diagnose your condition. As part of this exam, your doctor may do the following:
- Check whether the oxygen levels in your blood are low. This may be done by pulse oximetry, in which a probe is placed on your finger to check your oxygen levels.
- Feel your liver to see if it is larger than normal.
- Listen to your heart to see if there are changes in how it sounds, and also to find out if your heartbeat is faster than normal or irregular or if you have a new heart murmur.
- Listen to your lungs for sounds that could be caused by heart failure or interstitial lung disease.
- Look at the veins in your neck to see if they are larger than normal.
- Look for swelling in your abdomen and legs that may be caused by fluid buildup.
- Measure your blood pressure.
Follow Up Care For Ph
While it can take weeks to months to notice a significant improvement with medical therapy, it is important to follow up closely with your PH specialist to make sure that there is improvement.
Patients will follow up within three months of their diagnosis.
If they are doing well, they will follow up every six to 12 months for continued monitoring of their disease.
Follow up can involve repeat testing including:
- The six-minute walk test
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What Is Primary Pulmonary Hypertension
Primary pulmonary hypertension is high blood pressure in the lungs. Its a rare lung disorder in which the blood vessels in the lungs narrow and the pressure in the pulmonary artery rises far above normal levels. The pulmonary arteries carry blood from your body to the lungs where carbon dioxide is traded for oxygen.
Pulmonary hypertension is a serious, chronic disease that can lead to heart failure if its not treated.
How Does Pulmonary Arterial Hypertension Caused By Ed
You see pulmonary arterial hypertension is a disorder that relates to a blood flow problem.
When you are suffering from pulmonary arterial hypertension the blood flow to the other parts of the body including the penis is likely to get hampered.
ED is the failure of a man to get penis hard even after stimulating or moving the penis. This is a sexual disorder that may seem distantly related or have no relation whatsoever with pulmonary arterial hypertension.
ED is a disorder that may seem to have various physical and psychological problems associated with it.
But the main problem that is common in all the problems that lead to an ED is the insufficient flow of blood through the penis tissues. You see the normal psychology says that when you have an erection blood flow to the penis tissues increases naturally and tempting or stimulating the penis would lead to an erection.
But as those patients who are suffering from pulmonary arterial hypertension are already having weakened blood flow the blood flow through the penis is not as sufficient as a normal person.
This means that a lower blood flow isnt able to simply cause the stimulating effects to the penis let it become erect.
This is why male patients suffering from pulmonary arterial hypertension have more chances of suffering from erectile dysfunction.
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Preparing For Your Heart Catheterization
Before the heart catheterization a doctor will explain the risks and benefits of this procedure. You will remain without food or drink 12 hours before the procedure. You may take you regular a.m. medications on the day of the procedure however you should hold any blood thinners or diabetic medications.
Irregular Heartbeat And Chest Pain
Increased pressure in the heart makes the hearts muscles work harder than they should. Over time, these muscles grow weaker. A weakened heart cant beat as well or as regularly as it once did. Ultimately, this may cause an erratic heartbeat, a racing pulse, or heart palpitations.
Increased blood pressure in the heart and arteries may cause chest pain or pressure. An overworked heart may also cause unusual chest pain or chest pressure.
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Recognizing The Initial Symptoms
The first symptoms of PAH, especially shortness of breath and fatigue, may make you think youre just out of shape. After all, its not uncommon to get out of breath after climbing several sets of stairs, even if youre physically active every single day. For that reason, many people ignore the symptoms of PAH and let the disease progress without treatment. This makes the condition worse and potentially fatal.
When To See A Gp
See a GP if you have any symptoms of pulmonary hypertension. They may ask you about your symptoms and medical history, and they may carry out a physical examination.
Correctly diagnosing pulmonary hypertension can sometimes take time because its symptoms are similar to those of many other heart and lung conditions.
Tests you may have include a type of heart scan called an echocardiogram, and right heart catheterisation, where a thin, flexible tube is inserted into your pulmonary artery.
The changes in the pulmonary arteries that lead to pulmonary hypertension can be caused by:
- problems with the smaller branches of the pulmonary arteries
- conditions that affect the left side of the heart
- lung diseases or a shortage of oxygen in the body
- blood clots that cause narrowing or a blockage in the pulmonary arteries
Read more about the causes of pulmonary hypertension.
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The Pulmonary Hypertension Life Expectancy
The problem of people who are suffered from final stages pulmonary hypertension is the worse condition. Mostly, the health condition will be decreased constantly although they are taking a proper treatment. Of course, it doesnt mean that you dont do anything. Taking a proper treatment determines the life expectancy. In the earlier phase or people with PHA less than 1 year, they still have up to 85% of life expectancy. If they are suffered from this disease for 3 years the life expectancy is reduced up to 65%. In the final stages pulmonary hypertension or up to 5 years, the chance to live is around 57%. It can be concluded that the life expectancy is still bigger as long as you follow the medication constantly. The life expectancy is also depending on your health condition and also the type of pulmonary hypertension you have.
Learn The Warning Signs Of Serious Complications And Have A Plan
Even with treatment, pulmonary hypertension may lead to serious complications such as heart failure and arrhythmias. Know the signs and symptoms of pulmonary hypertension and how to recognize the possible complications.
If you are taking a blood thinner, this will increase your risk of bleeding. If you experience any abnormal bleeding, such as blood in your stool, black stool, or coughing up blood, contact your doctor right away. If you fall while taking a blood thinner, you are at higher risk for bleeding inside your head. Let your doctor know if you have fallen while taking a blood thinner.
Some treatments for pulmonary hypertension must be given through a long-term intravenous line. Call your doctor right away if you have any signs of infection. Signs of infection include redness, swelling, or yellow discharge where the IV is inserted a fever of 100.3°F or higher and chills.
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Lifestyle And Activity Adjustments
- consuming a heart-healthy diet consisting of fruits, vegetables, and whole grains
- reaching or maintaining a moderate weight
- staying active
Although physical activity is important for health, a person should avoid lifting heavy weights or doing other activities that cause strain.
PAH is a progressive condition, which means that the condition will worsen over time.
A 2012 evaluation found that in the last 20 years, the survival rate for PAH has improved.
The survival rate refers to the number of people in either a study or treatment group who are still alive for a length of time after receiving a diagnosis. For example, a 5-year survival rate of 50% indicates that 50%, or half, of the people who receive a diagnosis are still alive 5 years afterward.
It is important to remember that these figures are estimates that are based on the results of previous studies or treatment groups. A person can talk with a doctor about how their condition is likely to affect them.
The researchers behind the evaluation reported the following survival rates for individuals with PAH of unknown cause:
- the 1-year survival rate is about 91%
- the 3-year survival rate is about 74%
- the 5-year survival rate is about 65%
- the 7-year survival rate is about 59%
How Common Is Pulmonary Hypertension
There are many different types of pulmonary hypertension and some are associated with underlying health conditions, particularly conditions affecting the heart or lungs. Pulmonary hypertension may be more common in people with:
- sickle-cell anaemia
- chronic obstructive pulmonary disease
Generally, pulmonary hypertension can affect people of almost any age, although some types are more common in young women and some in people aged over 40.
One type of pulmonary hypertension, called pulmonary arterial hypertension , is more common in women and affects two to four people in every million each year.
More about the causes of pulmonary hypertension
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Causes And Risk Factors Of Pulmonary Hypertension
Pulmonary hypertension may be caused by a few factors, including health conditions that cause damage to your lungs, the left side of your heart, or your pulmonary arteries. But identifying pulmonary hypertension causes can be difficult, and sometimes no specific cause is determined.
In some people with a family history of pulmonary hypertension, a gene mutation has been identified that researchers believe contributes to the disorder. But some people with no known genetic factors also develop pulmonary hypertension.
Health conditions that may cause or contribute to pulmonary hypertension include these issues:
- Blood clots in the lungs
- Tumors in the lungs
- Left-sided heart disease
- Congenital heart defects
- Surgical removal of the spleen
Certain other factors may contribute to pulmonary hypertension, as well:
- Family history of the condition
- Living at a high altitude
- Older age
- Being a woman
- Exposure to asbestos or silica
- Taking certain weight loss drugs
- Taking certain chemotherapy drugs for cancer
- Using certain illegal drugs, including cocaine
How Is It Different From Systemic Blood Pressure
Systemic blood pressure is a measure of how forcefully blood flows through other arteries in the body.
The Centers for Disease Control and Prevention note that normal systemic blood pressure is below 120/80 mm Hg, where the top number represents systolic blood pressure and the bottom diastolic.
A person has hypertension if their blood pressure is 130/80 mm Hg or higher, and doctors may recommend treatment when a persons blood pressure is consistently 140/90 mm Hg or higher.
Systemic hypertension is more common than PAH. Although both are risk factors for heart disease, PAH is more likely to cause heart failure. Over time, systemic hypertension may damage the heart, causing PAH.
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Ph Associated With Congenital Heart Disease
A child may be born with a hole in the septum of the heart. The septum is the wall that separates the right and left side of the heart.
If the hole is between the two upper chambers, it is called atrial septal defect . Most ASDs are repaired during childhood however, it is possible to repair these holes at any age if there is little to no signs of pulmonary hypertension that exists.
If the hole is between the two lower chambers it is called a ventricular septal defect. . Ventricular septal defects are the most common congenital heart defects. When a defect is present, blood can flow across the hole from the left side of the heart to the right. Children born with VSDs are more likely to develop pulmonary hypertension than those with ASDs if they are not closed early in life. The reason is because there is excessive blood flow and pressure through the hole into the right side of the heart and lungs that results in enlargement of both the right atrium and ventricle. Over time the extra blood flow into the lungs causes damage to the blood vessels resulting in pulmonary hypertension.
Taking Care Of Yourself
One of the best things you can do for yourself is to stay active, even if you have shortness of breath. Regular exercise, like taking a walk, will help you breathe better and live better. Talk to your doctor first to find out what kind of exercise is best for you, and how much you should do. Some people may need to use oxygen when they exercise.
Get plenty of rest, too. Pulmonary hypertension makes you tired, so get a good night’s sleep and take naps when you need to.
Just like anyone else, it’s good for you to eat a healthy diet with lots of fruits, vegetables, and whole grains. That’s important for your overall health.
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Who Gets Pulmonary Hypertension
It can affect people of any age.
But one type of pulmonary hypertension, pulmonary arterial hypertension is more common in women. Some research suggests that this is due to differences between male and female hormones.
Pulmonary hypertension can happen by itself, be caused by another heart or lung condition or be associated with other medical conditions such as connective tissue conditions.
The Exact Cause Of Pah Is Unknown But Physiological Changes Are Key To Its Development And Progression
PAH is diagnosed when mean, or average, blood pressure leaving the arteries on the right side of the heart is measured at 25 mmHg or higher. No one knows exactly what kicks off the chain of events that sets PAH in motion, but experts do know a lot about how it progresses.
“It starts with constriction of these vessels and leads to remodeling of the vessel wall,” says Alessandro Maresta, M.D.Alessandro Maresta, M.D.,Vice President and Head of Global Medical Affairs, Actelion Pharmaceuticals, Vice President and Head of Global Medical Affairs for Actelion Pharmaceuticals, a Swiss biotech company that Johnson & Johnson acquired in June of this year. “As the walls of the blood vessels thicken, the lumenthe space where blood flows throughgets smaller, and the pressure goes up. As the disease progresses, pressure continues to rise, but the right ventricle of the heart is not designed to pump blood against such high pressure.”
As the condition worsens, “patients tend to become very tired and short of breath,” says Nazzareno Galié, M.D., professor of cardiology and Director of the Specialization School of Cardiology, University of Bologna, Italy. “Some people might notice heart palpitations or feel chest pressure, especially when exercising.”
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Pah Is Difficult To Diagnose
Given how rare PAH is, when a patient complains about such symptoms as exhaustion and labored breathing, it’s not unusual for a doctor to first order testing for conditions like asthma and congestive heart failure.
While that makes sense on some levelthose issues are much more common than PAH, explains Galiéit also means that getting diagnosed with PAH may sometimes take a while.
“You might see a general practitioner, then a specialist for asthma, then another specialist and so on before finally seeing a pulmonologist or cardiologist who diagnoses the PAH,” Maresta explains. “It usually takes one year from the presentation of symptoms to get a correct and final diagnosis of PAH.”
Plus, notes Galié, “your doctor will also need to rule out all other forms of pulmonary hypertension before giving a diagnosis of PAH.”
But the good news is that the timeline to PAH diagnosis is starting to speed up a little. “Things are slowly changing, as more doctors now know what PAH is and how to identify it,” Maresta explains.
Once your physician suspects PAH, your doctor will order a series of tests that may include a chest X-ray, pulmonary function test and exercise tolerance test. If all signs still point to PAH following the results of these tests, you’ll probably require a right-heart catheterization, which measures the pressure inside the pulmonary arteries.