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pulmonary hypertension

On Health & Drugs & Medications » Respiratory Diseases

6,029 words with 5 Comments; publish: Fri, 14 Dec 2007 14:09:00 GMT; (90062.50, « »)

what is it and what does it mean?my doctor told me i just need to lose weight and exercise.

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  • 5 Comments
    • First I'll explain what it is: Any kind of hypertension means that there is an increased pressure on the walls of a vessel, in this case the pulmonary vessels. The pulmonary arteries are vessels that allow deoxygenated blood to travel from the heart to the lungs. The pulmonary veins are vessel that allow oxygenated blood to then travel from the lungs back to the heart (where it is then pumped into the systemic circulation).

      Pulmonary HTN is, at it's core, the same thing as regular old hypertension (high blood pressure), but a bit more serious because it involves the lungs and the heart directly. There are two ways to develop any kind of hypertension, pulmonary or otherwise: the amount of space/area within the vessel can be decreased (vasoconstriction or increased thickness of the vessel walls) or there can be an increase in the amount of fluid in the the vessels (too much protein in the blood or not enough blood flow [causing blood to back up and exert high pressures]).

      There are two types of pulmonary HTN, primary and secondary. I would be very surprised if you had primary, as it is extremely rare (only about 2-3 cases per million). If your doctor suspected you have this, he would not have blown it off - for this reason (and the extreme rarity of the disease), I suspect you have secondary pulmonary HTN (SPH).

      SPH is cause by numerous different things - COPD, living at a high altitude, cirrhosis, pulmonary embolism, sickle cell disease, sleep apnea, congestive heart failure, congenital heart deformities - there are even more, but you get the point. The reason there are so many causes is because of what I said ealier about how one gets HTN in the first place. All of these things somehow or another cause blood to build up in the pulmonary vessels, increasing the pressure within them.

      So here is what I'm not understanding - none of these are relieved by exercise and diet changes. Unless your doctor feels that you are developing atherosclerotic pulmonary vessels, I'm not quite sure what a diet change will do for you (this IS a possibility though, so I won't discount it). Do you have any other medical problems? Are you on any medications? Aside from vasodilators and diuretics, the only way to take care of SPH is to treat the underlying condition that is causing it. Can you tell us anything else about your history that might be important?

      #1; Sat, 15 Dec 2007 16:18:00 GMT
    • Fudd...what a wonderful post about PHTN.

      I agree with you, diet and exercise aren't going to change anything, but they will help the patient stay generally healthy and prevent things like deconditioning or exacerbation of cardiovascular health.

      What I want to know is how the doctor knows that you have pulmonary hypertension. Have you had an echocardiogram done? Have you had a catheter put in to your heart? Do you have any lung diseases? Having someone just tell you you have pulmonary hypertension is really strange without wanting to do more investigations.

      #2; Sat, 15 Dec 2007 16:19:00 GMT
    • See:

      http://www.americanheart.org/presenter.jhtml?identifier=4752

      Primary or Unexplained Pulmonary Hypertension

      "AHA Recommendation

      There is extremely wide variability in the severity of pulmonary hypertension among various patients. Evaluating, accurately diagnosing and treating the condition is also very complex. For these reasons, patients with symptoms that suggest pulmonary hypertension require thorough evaluation at a medical center with expertise and experience in

      pulmonary hypertension."

      -----------

      http://www.americanheart.org/presenter.jhtml?identifier=11076

      Pulmonary Hypertension

      "High blood pressure in the arteries that supply the lungs is called pulmonary hypertension (PHT)....................

      If a pre-existing disease triggered the PHT, doctors call it secondary PHT. That's because it's secondary to another problem, such as a heart or lung disorder. Congenital heart disease can cause PHT. .............

      Once PHT has been diagnosed, often more medical therapy is needed. You'll require regular follow-up with a cardiologist or pulmonologist trained in caring for patients with PHT..................

      Once PHT has been diagnosed, you must seek advice about physical activity. If you have PHT, you should be as active as physically possible. Physical activity can be associated with marked increases in pulmonary artery pressure. Thus, don't do isometric exercises and activities that produce dangerous symptoms, such as chest pain or dizziness. A

      supervised cardiopulmonary rehabilitation program may help promote conditioning. Many patients with PHT report having "good and bad days." If you need to rest, do so. "

      #3; Sat, 15 Dec 2007 16:20:00 GMT
    • thanks for all the info.i am seeing a cardiologist and he did do an echo.that is how he found out about the pulmonary hypertension.i am extremely overweight and do little exercise.that is why he came up with that.he thinks it is caused by my weight.my other issues are depression and anxiety,temporal lobe seizures,high blood pressure(controlled by meds),stomach problems.he does think i have sleep apnea and wants me to do a sleep study.he also mentioned i have a leaky mitral valve and thickening of the walls.

      the reason i am seeing him in the first place is b/c i had a bad round of bronchitis and i was always out of breath.my pcp sent me there to rule out any heart problems.so much for that!

      #4; Sat, 15 Dec 2007 16:21:00 GMT
    • I will admit that I've never heard of pulmonary hypertension secondary to obesity.

      But perhaps a pickwickian thing could be happening with the obesity -- have you ever been evaluated for obstructive sleep apnea?

      Edit: as I actually finish reading your last post -- yes. Treatment for sleep apnea you might find actually makes it easier for you to lose weight -- more energy, a faster metabolism, that kind of thing. I hope it works well for you!

      #5; Sat, 15 Dec 2007 16:22:00 GMT