Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of your heart.
Pulmonary hypertension symptoms include:
• Shortness of breath (dyspnea), initially while exercising and eventually while at rest
• Fatigue
• Dizziness or fainting spells (syncope)
• Chest pressure or pain
• Swelling (edema) in your ankles, legs and eventually in your abdomen (ascites)
• Bluish color to your lips and skin (cyanosis)
• Racing pulse or heart palpitations
The first tests you'll have to diagnose pulmonary hypertension include:
• Blood tests. Your doctor may order blood tests to check for certain substances in your blood that may show you have pulmonary hypertension or its complications.
• Chest X-ray. This test may be able to check for pulmonary hypertension if your pulmonary arteries or the right ventricle of your heart is enlarged.
• Doppler echocardiogram. Your doctor may first suspect you have pulmonary hypertension based on the results of this test. This noninvasive test uses sound waves that allow your doctor to see your heart without making an incision..
• Transesophageal echocardiogram. If it's difficult to get a clear picture of your heart and lungs with a standard echocardiogram, your doctor may recommend a transesophageal echocardiogram.
• Right heart catheterization. After you've had an echocardiogram, if your doctor thinks you have pulmonary hypertension, you'll likely have a right heart catheterization.
• Pulmonary function test. This noninvasive test measures how much air your lungs can hold, and the airflow in and out of your lungs. During the test, you'll blow into a simple instrument called a spirometer.
• Perfusion lung scan. This test uses small amounts of radioactive substances (radioisotopes) to study blood flow (perfusion) in your lungs. The radioisotopes are injected into a vein in your arm. Immediately afterward, a special camera (gamma camera) takes pictures of blood flow in your lungs' blood vessels. A lung scan can then be used to determine whether blood clots are causing symptoms of pulmonary hypertension.
• Computerized tomography (CT) scan. A CT scan allows your doctor to see your organs in 2-D "slices." In this test, you'll lie in a machine that takes images of your lungs so that your doctors can see a cross-section of them. You might also be given a medication that makes the images of your lungs show up more clearly.
• Magnetic resonance imaging (MRI). This test, which uses no X-rays, is sometimes used to get images of the blood vessels in your lungs.
• Open-lung biopsy. In rare situations your doctor may recommend an open-lung biopsy. An open-lung biopsy is a type of surgery in which a small sample of tissue is removed from your lungs under general anesthesia to check for a possible secondary cause of pulmonary hypertension
Treatment is determined by whether the PH is arterial, venous, hypoxic, thromboembolic, or miscellaneous.
• Medical Management
• Surgical treatment
Atrial septostomy: is a surgical procedure that creates a communication between the right and left atria. It relieves pressure on the right side of the heart, but at the cost of lower oxygen levels in blood (hypoxia)
Pulmonary thromboendarterectomy (PTE) is a surgical procedure that is used for chronic thromboembolic pulmonary hypertension. It is the surgical removal of an organized thrombus (clot) along with the lining of the pulmonary artery.
Consult at Aadil Hospital for medical and surgical treatment.
