Pulmonary Arterial Hypertension - Types, Causes, and Diagnosis

Introduction

Pulmonary hypertension or PHT refers to high blood pressure in the heart that passes down to the lung responsible for delivering fresh or oxygenated blood to the heart and returning deoxygenated or oxygen-depleted blood to the lungs. Systemic blood pressure is a reading of the pressure exerted by the continuous pumping of the heart. The heart pumps blood and gushes blood within the arteries of the body. On the other hand, pulmonary hypertension refers to the pressure exerted by the blood vessels that connect the lungs.

What Are the Types of Pulmonary Hypertension?

The World Health Organization (WHO) has developed four categories of pulmonary arterial hypertension, as mentioned below.

• Group 1 is a kind of pulmonary arterial hypertension with no cause and may be inherited. At times, this kind of pulmonary arterial hypertension may result from connective tissue disorders, body infections such as the human immune virus, sickle cell disease, liver abnormality, congenital heart disease, and the influence of certain medications.

• Group 2 is a kind of pulmonary arterial hypertension that develops due to a disease in the heart's mitral valve. The left side of the heart is most commonly affected by group 2 pulmonary arterial hypertension.

• Group 3 is a kind of pulmonary arterial hypertension that leads to certain issues of the lungs, for instance, chronic obstructive pulmonary disease, known as COPD, as well as sleep apnea and interstitial lung diseases. Several other naso-oral conditions may also be developed over time.

• Group 4 is a kind of pulmonary arterial hypertension that directly results from blood clots within the lungs.

• Group 5 is a kind of pulmonary arterial hypertension triggered by an underlying disease. Mentioned below are a few of the trigger factors of pulmonary arterial hypertension.

• Polycythemia vera.

• Thrombocytopenia.

• Thrombocythemia.

• Vasculitis.

• Sarcoidosis.

• Thyroid.

• Kidney diseases.

• Tumor.

• Glycogen storage disorders.

How Does Blood Flow From the Heart to the Lungs and Vice Versa?

The heart has four chambers- two upper sections, the right atrium, and left atrium, and two lower sections, the right ventricle and left ventricles. Parallel to four chambers, the heart has four valves: mitral, tricuspid, aortic, and pulmonary valves. The mitral or bicuspid valve allows blood to flow smoothly from the left atrium into the left ventricle. It has two leaflets. The tricuspid valve allows blood to flow easily from the right atrium into the right ventricle. It has three leaflets. The pulmonary valve primarily allows smooth blood flow from the right ventricle into the pulmonary artery. It has three leaflets.

The steps of blood flow from the heart to the lungs are mentioned below.

• The lower right section of the heart receives deoxygenated blood and pumps it to the pulmonary arteries.

• This blood moves to the lungs to receive a sufficient amount of oxygen.

• It then moves to the left atrium or the upper left section of the heart.

• The blood is now rich in oxygen and moves into the left ventricle or the lower-left section of the heart.

• The blood is then pumped to the rest of the body via the aorta.

• The aortic valve controls smooth blood flow from the left ventricle to the aorta. Aorta is known to be the largest blood vessel of the heart as well as the entire body. It is highly flexible, and is why blood flows out of the heart into the rest of the body. It has three leaflets.

What Are the Signs and Symptoms of Pulmonary Hypertension?

The clinical manifestations of pulmonary hypertension can be understood if the patient reveals a few or all of the below-mentioned signs and symptoms of pulmonary hypertension.

• Shortness of breath.

• Fatigue.

• Chest pain.

• Increase in heart rate.

• Pain in the right upper side of the abdomen.

• Loss of appetite.

• Feeling light-headed.

• Dizziness during physical activities.

• Fainting.

• Swelling of the ankles or legs.

• Bluish discoloration of the lips.

• Cyanosis.

• Asthma

What Are the Factors That Influence Pulmonary Hypertension?

Pulmonary hypertension is a condition where the blood pressure of the arteries that connect the lungs and the heart is met.

A few of the factors that influence pulmonary hypertension are mentioned below.

• Age

• Fitness level.

• Physical activeness.

• Smoking.

• Presence of cardiovascular disease.

• High cholesterol.

• Diabetes mellitus.

• Air temperature.

• Standing up.

• Lying down.

• Emotions.

• Body size.

• Medications.

What Causes Pulmonary Arterial Hypertension?

An increase in the blood pressure of the arteries connecting the heart and the lungs may result from a range of activities as well as physiological disturbances.

Below are a few possible reasons that may result in pulmonary arterial hypertension.

• Aging.

• Stress.

• Obesity.

• Drinking coffee.

• Smoking.

• Pregnancy.

• Standing up all of a sudden.

• Intense physical activity.

• Drinking alcohol.

• Living in a tropical country.

• Certain medications.

• Drugs.

• Anxiety.

• Issues with the heart's conduction system.

• Fear.

• Anemia.

• Infection.

• Elevated thyroid hormone.

• Dehydration.

• Stress.

• Fever.

How Is the Diagnosis of Pulmonary Hypertension Made?

To diagnose a case of pulmonary hypertension, the healthcare provider may ask about the signs and symptoms and the risk factors, including medical conditions. Being aware of the family history is also necessary.

Mentioned below are a few diagnostic measures that the health care professional may conduct to confirm the diagnosis of pulmonary arterial blood pressure.

• Medical evaluation.

• Echocardiography.

• Chest X-ray.

• Electrocardiogram.

• Catheterization of the heart.

• Chest CT scan.

• Chest MRI (magnetic resonance imaging).

• Lung function tests.

• Polysomnogram or PSG.

• Lung ventilation.

• Perfusion scan.

• Complete blood picture.

Conclusion

Pulmonary arterial hypertension has no definite cure. Individuals can live a fulfilled life with this condition, provided the prescribed medications and lifestyle habits are within limits. Pulmonary arterial hypertension requires strict management. An individual that is suffering from pulmonary arterial hypertension must quit smoking. They must eat a diet rich in fruits and vegetables and low in cholesterol, sugar, and sodium. Maintaining the ideal weight is an added key factor to optimum levels of pulmonary arterial hypertension.