Treatment and signs of pulmonary hypertension
A pathological condition for which the inherent increase in pressure in the pulmonary artery, in medicine called pulmonary hypertension. Disease frequency takes the third place worldwide among the vascular diseases typical for the elderly.
Causes of pulmonary hypertension
Pulmonary hypertension may be a congenital anomaly, that is, primary or acquired, which is called the secondary.
The reason for the increase in pressure in the arteries of the lungs there may be the following factors:
- heart failure;
- heart defects of various origins;
- chronic lung diseases, including tuberculosis, bronchial asthma, etc.;
- Pulmonary embolism or other pulmonary vascular lesions;
- metabolic disorders;
- being in the mountainous regions.
In cases when the exact cause of hypertension install is not possible, the doctor makes a diagnosis of primary hypertension. As a painful condition of unknown origin, primary pulmonary hypertension can be provoked by different means of contraception or result from autoimmune disease.
Secondary pulmonary disease can be caused by abnormalities of the heart muscle, lungs or blood vascular.
Classification of the disease
Depending on the severity of the occurrence of the painful condition doctors have identified 4 classes of patients:
- The first stageis not accompanied by loss of physical activity. The patient with pulmonary insufficiency, can withstand the normal loads without the appearance of weakness, dizziness, pain in the chest or shortness of breath.
- In the second stage of the disease physical activity of the patient is limited. At rest, no complaints, but the usual load causes a pronounced shortness of breath, dizziness and fatigue.
- Third stage hypertension causes the above symptoms with the slightest physical activity of a person suffering from this disease.
- Pulmonary hypertension the fourth stage is marked by pronounced signs of weakness, shortness of breath and pain even when the person is in a state of absolute rest.
Symptoms of pulmonary insufficiency
The main symptom of the disease is shortness of breath that has several specific features allowing to distinguish it from symptoms of other diseases:
schematic structure of the blood vascular of the lungs
- is observed indormant;
- its intensity increases with minimal exercise;
- in a sitting position shortness of breath does not stop, in contrast to the breathlessness of cardiac origin.
Other signs of pulmonary hypertension also characteristic of most patients:
- weakness and fatigue;
- constant dry cough;
- swelling of the feet;
- pain in the liver area caused by its increase;
- pain in the chest due to the fact that the pulmonary artery is expanded;
- in some cases there is a hoarse voice. Due to the fact that the artery during the expansion infringes on the laryngeal nerve.
Thus pulmonary hypertension, the symptoms of which are often not specific, is not always possible to establish the correct diagnosis without a range of surveys.
Diagnosis of the disease
As a rule, patients come to physicians with complaints about the expressed shortness of breath that prevents them in real life. Because primary pulmonary hypertension has no specific symptoms, allowing the safe to make a diagnosis at the first visit of a physician, diagnosis should involve a cardiologist and a pulmonologist.
The complex procedures involved in the process of diagnosis includes the following methods:
- medical examination and fixation of the history. Often the disease has a genetic cause, it is therefore essential to collect information about family illnesses;
- clarifying the current lifestyle of the patient. Smoking, no physical activity, intake of various medications - it all matters when explaining the causes of shortness of breath;
- a General inspection. On it the doctor is able to identify the physical condition of the veins in the neck, skin color (bluish in the case of hypertension), enlargement of the liver, the occurrence of edema in the legs, thickening of the fingers;
- electrocardiogram. The procedure allows to reveal changes in the right chamber of the heart;
- echocardiography helps to determine the speed of passage of blood and General condition of vascular;
- CT will show a layer-by-layer way picture increase the pulmonary arteries and possible concomitant diseases of the lungs and heart;
- x-ray light will allow you to observe the state of the artery, its expansion and contraction;
- catheterization technique is used for accurate measurement of the pressure inside the pulmonary artery. Doctors believe this procedure is not only the most informative for obtaining pressure values, but also associated with minimal risk of complications;
- test "6 minute walk" helps determine the physical reaction of the patient to load and set the class of hypertension;
- blood test:biochemical and;
- angioplasty allows using the introduction in the vessel of a special contrast medium to obtain a complete picture of vascular in the region of the pulmonary artery. The method must be applied with greater caution, since it can provoke hypertensive crisis patient.
Thus, pulmonary hypertension should be diagnosed only after a thorough comprehensive study of the condition of the vascular of the patient, to exclude the formulation of misdiagnosis.
The reason for going to the doctor
The patient should consult the doctor in case if it feels the following signs of illness:
- the emergence or increased shortness of breath when performing normal daily load.
- the pain of undiagnosed origin in the chest area;
- if the patient has unexplained feeling of fatigue;
- the appearance or increase in the degree of swelling.
Treatment of pulmonary insufficiency
In most cases of primary pulmonary hypertension is treatable. The main guidelines when choosing methods of treatment are:
- identifying and eliminating the causes of the patient's condition;
- lowering the pressure in the arteries of the lung;
- preventing the formation of blood clots in the vascular system of the patient.
In the appointment of treatment the doctor may prescribe the following medications:
- drugs acting on relaxing the muscle layer of blood vascular. This group of drugs is very effective in the early stages of the disease. Pulmonary hypertension, treatment of which was begun before vascular changes become pronounced, and irreversible, have very good chances of complete freedom of the patient from the symptoms;
- medications designed to reduce blood viscosity. If blood clots are very pronounced, your doctor may decide on the blowing of blood. The hemoglobin level in these patients should not exceed the level of 170 g/l;
- when severe shortness of breath and hypoxia shows oxygen inhalation as a means of removing the unpleasant physiological symptoms;
- the doctor may recommend to reduce the consumption of salt in the diet and reduce the fluid intake to one and a half liters of pure water a day;
- a strict ban on strenuous physical activity. Only permitted such activity, in which the patient does not feel discomfort and painful symptoms;
- if pulmonary hypertension is accompanied by complication of insufficiency of the right ventricle of the heart, the doctor prescribes regular use of diuretic medicines;
- in the most advanced cases of the disease resort to the procedure of heart and lung transplantation.The methodology is still insufficiently worked out in practical conditions, but the statistics of such transplants evidence of their effectiveness.
Among the negative consequences of disease can highlight the main:
- worsening of heart failure. The right parts of the heart may cease to cope with their current load, what else affects the position of the patient;
- condition called pulmonary embolism - thrombosis of an artery in the lung when a blood clot occludes a vessel. This disease is not only dangerous, but directly threatens the patient's life;
- hypertensive crisis associated with edema of the lung.
As a rule, the disease significantly lowers the quality of life of the patient and in most cases leads to premature death.
While pulmonary hypertension causes of chronic or acute cardiac and pulmonary failure, life-threatening patient.
In order for the risk of the disease was minimal, you must take the following actions:
- adhere to healthy lifestyle. In particular, it is necessary categorically to give up Smoking, and daily exercise;
- you need to promptly identify and treat underlying diseases that cause hypertension. This is possible in the case of regular preventive visits to the doctor;
- common diseases of the bronchi and lungs, with chronic nature, it is necessary to carefully observe the course of the disease. Clinical supervision will help to avoid complications of the disease and facilitate its flow;
- diagnosed with pulmonary hypertension is not a ban on any physical activity. On the contrary, such patients shown moderate load in the fresh air. Activity must be regular, but in any case not more intense;
- all situations that entail stress, should be deleted. Conflicts at work, at home or in public transport may cause an exacerbation of the disease.
Thus, the sooner a patient seeks the medical advice and the more carefully followed his instructions, the more chances you have to suspend the course of the disease and not move him to a more serious stage, is worse treatable.
We recommend you to read about what is pulmonary embolism.