Pulmonary Hypertension

Conditions Basics

What is pulmonary hypertension?

Pulmonary hypertension is high blood pressure in the arteries of your lungs. This may also be called pulmonary arterial hypertension (PAH).

These arteries carry blood from the heart to the lungs, where the blood picks up oxygen. The walls of the arteries may get thick, which narrows the space inside the arteries. When this happens, blood does not flow as well as it should. Pressure builds up in the arteries. Then your heart has to work harder to pump blood through your lungs.

Pulmonary hypertension may cause heart failure. Heart failure means that your heart doesn't pump as much blood as your body needs.

It can be stressful to learn that you have a problem with your lungs and heart. But there are things you can do to feel better and stay as active as you can.

What causes it?

There are several types of pulmonary hypertension with different causes. For example, it may be caused by:

• Another disease. Many conditions can lead to pulmonary hypertension, including:
  • Heart disease, such as heart failure, a heart valve problem, or congenital heart disease.
  • Chronic lung disease, such as COPD or pulmonary fibrosis.
  • Blood clots in the lungs.
  • Connective tissue disease, such as scleroderma, lupus, or rheumatoid arthritis.
  • Sickle cell disease.
• Certain drugs or toxins.
• Inherited gene changes.
• Unknown causes. This is called idiopathic pulmonary hypertension.

What are the symptoms?

At first, you may not notice any problems. But in time, you may have symptoms such as:

• Shortness of breath.
• Feeling tired, faint, or dizzy.
• Swelling (edema) in your legs, ankles, feet, and belly.
• Chest pain.

How is it diagnosed?

It can be hard to diagnose pulmonary hypertension, because many other conditions can cause the same symptoms. If your doctor thinks you have it, you may have tests such as:

• A chest X-ray.
• Lung function tests.
• An echocardiogram, which is an ultrasound test of the heart.
• A CT scan of the lungs.

You may also have a cardiac catheterization. This test can check the blood pressure in the lung arteries. For this test, a doctor inserts a thin, flexible tube called a catheter into the heart through a blood vessel.

Your doctor may do other tests to look for what's causing the high blood pressure in your lungs.

How is pulmonary hypertension treated?

Your treatment options will depend on the type of pulmonary hypertension you have and how severe it is. If the cause was found, your doctor will give you treatment for that condition. You may be given special medicines to treat the high blood pressure in your lungs. These medicines work in different ways to help ease your heart's workload.

Other treatments that may be prescribed include:

• A diuretic to reduce fluid buildup.
• A blood thinner to help prevent blood clots.
• Oxygen therapy to make breathing easier.

Your doctor may suggest pulmonary rehab. This is a program that provides education and support for people with lung disease. Rehab may include an exercise program. Rehab can teach you ways to do your daily activities that save your energy as much as possible. It can also connect you with people who can help as you adjust to this disease.

Your doctor may also suggest hospice palliative care. Hospice palliative care is an extra layer of support that can improve your quality of life—not just in your body, but also in your mind and spirit. It can help you manage symptoms. It can also help you cope with your feelings about living with an illness.

Surgery, such as a heart or lung transplant or an angioplasty procedure, may be an option for some people.

Treatment can help you feel better and live longer. It may take some time to find the treatments that work best for you.

How can you care for yourself?

There are many things you can do to feel better and stay as active as you can.

Make the most of your energy

Be as active as you can.

Talk to your doctor before you start a new activity. Your doctor can help you choose a safe type and level of activity. Exercise may help you have more energy and improve your quality of life.

Learn ways to save your energy.

For example, arrange your home so things you use often are in easy reach. Put a stool in your shower so that you can sit down. Rest when you need to.

Get help with daily activities.

Friends or family members may be able to help with chores that are tiring or hard for you. Find out if your grocery store and drugstore will deliver.

Stay as healthy as you can

Try to avoid infections such as COVID-19, colds, and influenza (flu).

• Get a pneumococcal vaccine. If you have had one before, ask your doctor if you need another dose.
• Get the flu vaccine every year.
• Stay up to date on your COVID-19 vaccines.
• Wash your hands often.

Eat healthy foods, and try to stay at a healthy weight.

Healthy foods can help you have the energy you need.

If you smoke, try to quit.

Smoking can make this condition worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

Manage other health problems.

These include health problems that may make pulmonary hypertension worse, such as sleep apnea.

Talk with your doctor before travelling.

Your doctor may suggest that you use oxygen if you fly or visit a place that is at high altitude. Follow the instructions on how to use oxygen safely.

Manage your medicines

Take your medicines exactly as prescribed.

Be safe with medicines. Do not stop or change your medicines without talking to your doctor first. Talk to your doctor if you have problems with your medicines.

If you take a blood thinner, be sure to get instructions about how to take your medicine safely.

Blood thinners can cause serious bleeding problems.

Talk to your doctor before you take any over-the-counter medicines or natural health products.

Do not take ibuprofen (Advil or Motrin) or naproxen (Aleve) without talking to your doctor first.

Cope with your emotions

Having this disease can be stressful. Some people feel depressed that they can't do some of the things they used to do. Some people worry about their future. And symptoms such as shortness of breath can make this anxiety worse. It may help to:

Get emotional support from friends and family.

You might also think about joining a support group.

Learn ways to relax and manage stress.

You may want to try yoga or meditation.

Talk to your doctor if you feel sad and hopeless much of the time or if you are worried and anxious.

These may be signs of depression or anxiety. Treatment with counselling and medicine can help.

Prevent pregnancy

Talk to your doctor about preventing pregnancy. Pregnancy and childbirth can cause changes in the body that could be life-threatening for people who have this condition.