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PULMONARY HYPERTENSION: Causes, Signs and Treatment

PULMONARY HYPERTENSION: Causes, Signs and Treatment

PULMONARY HYPERTENSION: Causes, Signs and Treatment

Under the heading of Pulmonary Hypertension, a whole series of diseases are combined which have one thing in common: the blood pressure in the pulmonary circulation is increased. Pulmonary hypertension is said to happen when the average pressure in the small circulation grows above 25 mmHg. The signs at the start of pulmonary hypertension are weakness and performance impairment as well as briefness of inhalation while exercising.


Pulmonary Hypertension Definition: Pulmonary hypertension is a rare disease of the blood circulation of the lung and known as small circulation. In the small circulation (pulmonary circulation), the right half of the heart circulates the oxygen-poor blood to the lung. In the lung, the blood is supplemented with oxygen by a large system of small blood capillaries, and the oxygen-rich blood is then delivered to the right half of the heart.

If there is a disruption in this system, for example, by reducing these vessels, the pressure in the small circulation rises and the blood masses in the right half of the heart and then into the rest of the body. On the other hand, too little oxygen-rich blood comes into the large circulation.


Pulmonary hypertension Causes: Pulmonary hypertension is often caused by the death of the small retinal vessels in the lung, for example in a pulmonary emphysema. In the case of pulmonary embolism, the small vessels are clogged by blood clots. The disease is recognized into five distinct classes depending on the underlying condition. The two fundamental disorders of the pulmonary blood flow are pulmonary arterial hypertension and chronic thromboembolic hypertension.

Pulmonary hypertension can happen without an identifiable agent or in association with other diseases of the connective tissue, the liver, the heart as well as further illnesses. Chronic thromboembolic hypertension is a thromboembolic disease that can occur as a result of acute pulmonary embolism with a different latency period of up to decades but also without previous pulmonary embolism. In addition, Pulmonary Hypertension may be associated with cardiac insufficiency, pulmonary disease or unclear mechanisms. Common to all patients is an increased average pulmonary arterial pressure (mPAP> 25 mmHg) measured in the right heart catheter examination. A pre-capillary PH (PAWP <15 mmHg) or postcapillary PH (PAWP> 15mmHg) is defined according to end-expiratory pulmonary arterial wedge pressure.


Pulmonary hypertension Symptoms: At the beginning of pulmonary hypertension, fatigue and weakness in performance, as well as shortness of breath during loading, are the cause. These complaints occur in a large number of diseases, so the detection of the disease can be difficult. As a result, water accumulation (oedema), heartache, fainting, etc. can occur. Other symptoms include dyspnoea tightness in the chest. The main symptom is dyspnea during exertion, but also discomfort such as tiredness, thoracic tightness, cardiac arrhythmias and, in the case of advanced disease, circulatory collapse with sudden loss of consciousness


Pulmonary Hypertension Treatment: If possible, the cause of pulmonary hypertension is treated as long as it can be treated.  For many patients with Pulmonary Hypertension, the good treatment is the smoke stop, the oxygen and inhalation therapy at PH in lung diseases and the consequent treatment of cardiac insufficiency in PH in left heart disease.These include, for example, inhalation sprays in the case of pulmonary emphysema, blood-thinning drugs in pulmonary embolism and the treatment of cardiac insufficiency with heart medications. For the flushing out of the water, accumulations are used “water tablets”, with clear oxygen deficiency in the blood also the domestic oxygen delivery over the nose. In severe cases of pulmonary hypertension and in the forms without a recognizable cause, medicines are used which lead to an expansion of the network arteries in the lung (eg prostacyclin).

PULMONARY HYPERTENSION: Causes, Signs and Treatment

Without treatment, patients with PH have a rather limited prognosis. Only certain patients with CTEPH can be cured by surgical pulmonary endarterectomy. For the Group 1 Pulmonary Hypertension, various drug therapies have been developed in recent years that have shown efficacy in randomized studies and thus improve the prognosis of patients. For inoperable CTEPH patients, drug therapies have also recently been approved.


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