Pulmonary Hypertension

Pulmonary hypertension is an increased blood pressure in the blood vessels of the lungs.  This is caused by narrowing of blood vessels making it difficult for the heart to pump blood through this area.  It is very similar to trying to pump water through a small pipe versus a large one.  Generally, this situation leads to a variety of symptoms including shortness of breath, dizziness, fainting, tiredness, edema etc.  A hallmark of pulmonary hypertension is that the symptoms get worse after the onset of exercise.  The causes and specific symptoms of pulmonary hypertension depend on the origin of the problem.  With this in mind, pulmonary hypertension can be either venous, arterial, or disease related.  Often, pulmonary hypertension progresses slowly with gradual worsening of symptoms. 

Pulmonary Hypertension

Venous pulmonary hypertension occurs in the vessels taking oxygenated blood from the lungs to the left side of the heart.  The most common form of venous pulmonary hypertension is left heart failure, where the left ventricle of the heart does not pump blood effectively.  In this case, fluid “backs up” into the lungs increasing pulmonary blood volume resulting in pulmonary hypertension.  In severe cases, the venous pulmonary hypertension can carry backwards far enough to cause arterial pulmonary hypertension.  The most common symptom of venous pulmonary hypertension is pulmonary edema.   With this, many of these patients will also have trouble sleeping unless they are propped up by pillows

The source of arterial pulmonary hypertension is usually related to diseases affecting the pulmonary artery such as scleroderma, sarcoidosis, autoimmune disorders as well as drug induced pulmonary hypertension as a side effect.  Arterial pulmonary hypertension often results in right ventricle hypertrophy which progressively reduces the capability of the heart to pump blood.  Also, edema beginning around the ankles and progressing toward the head with progressive deterioration of the heart can also occur.

Lung disease often causes low blood oxygen levels and can also cause pulmonary hypertension.   These disease can cause unregulated narrowing of blood vessels, thickening and hardening of blood vessel walls, or even loss of vascular beds.  This increases resistance to blood flow and causes pulmonary hypertension.