PULMONARY

HYPERTENSION
VANDAR D. ADJUL
FREZY SILVESTRE
 WHAT IS
PULMONARY
HYPERTENSION?
• PAH is a specific type of high blood
pressure that affects your heart and lungs.
When you have PAH, the blood vessels in
your lungs become narrower. This means
your heart has to work harder to pump
blood to your lungs.
CAUSES OF PAH:
- IDIOPATHIC.
- The word idiopathic describes any disease that
develops for unknown reasons. The cause also could
be genetic—a gene mutation can cause PAH to
develop within families.
Other factors that can cause or contribute to PAH
include:
 Congestive heart failureBlood clots in the lungs
 HIV
 Drug use (including methamphetamine or cocaine)
 Liver disease (such as cirrhosis)
 Autoimmune diseases (eg, lupus, scleroderma, or
rheumatoid arthritis)
 Heart defects
 Lung disease (such as emphysema or chronic
bronchitis)
 Sleep apnea
 5 Classifications of Pulmonary Hypertension

Group 1: Pulmonary Arterial Hypertension

- refers to pulmonary arterial hypertension (PAH), which is caused when the arteries in the lungs
become narrowed, thickened or stiff. The right side of the heart must work harder to push blood through
these narrowed arteries. This extra stress can cause the heart to lose its ability to pump enough blood
through the lungs to meet the needs of the rest of the body.

Group 2: PH due to Heart Disease

- in this group of PH, the arteries and lungs are not as thick or stiff as group 1, but there are problems
with how the heart squeezes or relaxes, or problems with the valves on the left side of the heart. Because
of this, the left heart is unable to keep up with the blood returning from the lungs — causing a “backup”
of blood which raises pressure in the lungs. Group 2 is the most common form of PH.

Group 3: PH due to Unknown Causes

- is where PH is secondary to other diseases in ways that are not well understood. These associated
conditions include, but are not limited to, sarcoidosis, sickle cell anemia, chronic hemolytic anemia,
splenectomy (spleen removal) and certain metabolic disorders.
Group 4: PH due to Lung Disease
- includes PH due to chronic lung disease and/or hypoxia (low oxygen levels). These lung diseases
include obstructive lung disease where the lung airways narrow and make it harder to exhale (e.g. COPD
or emphysema); restrictive lung disease in which the lungs have a tough time expanding when one
inhales (e.g. interstitial lung disease or pulmonary fibrosis); sleep apnea; and living in an area of high
altitude for a long period of time. Arteries in the lungs tighten so that blood can only go to areas of the
lungs that are receiving the most air and oxygen. This tightening leads to high blood pressure throughout
the lungs.

Group 5: PH due to Blood Clots in the Lungs

- is called chronic thromboembolic pulmonary hypertension (CTEPH). CTEPH can occur when the
body is not able to dissolve a blood clot in the lungs. This can lead to scar tissue in the blood vessels of
the lungs, which blocks normal blood flow and makes the right side of the heart work harder. This type
of PH is unique because it can potentially be cured through pulmonary thromboendarterectomy (PTE)
surgery to remove the blood clots. However, not all CTEPH patients are eligible for this surgery. A drug
is also available for CTEPH patients if a doctor determines that a patient is not a candidate for the PTE
surgery or if PH remains after the surgery.
 SIGNS and
Diagnosis Complications
SYMPTOMS

Common symptoms of PAH  Blood Test

can include the following:  Cardiac Disorders
 Chest X-Ray
 Chest pain  Clot formation or
 Shortness of breath  Electrocardiogram
 Dizziness  Echocardiogram bleeding.
 Fatigue  CT scan  Arrythmia and
 Irregular heartbeat  Pulmonary palpitations.
 Lightheadedness, fainting Angiogram
Swelling in
Lower
Extremities
 Treatment

 Supplemental Oxygen Surgery and procedures for

 Anticoagulants pulmonary hypertension:
 Digoxin  Lung Transplant
 Calcium Channel  Pulmonary
Blockers Endarterectomy
 Diuretics  Arterial Septostomy