Pulmonary hypertension, or PH, is a disorder that causes the blood vessels in the lungs to get narrow and stiff. It overworks the right side of the heart as it pumps blood through the lungs, eventually causing heart muscles to weaken and potentially fail. There are many types of PH, with symptoms ranging from mild to severe, and the disease affects every person differently. Although there is no cure, treatment can reduce symptoms and improve one’s quality of life. Finding a specialist who can diagnose PH and treat it properly is necessary for successful management of this condition.
How the Circulatory System Works
The lungs and heart work together to supply the body with oxygen. The heart is a big muscle made up of two upper chambers (atria) and two lower chambers (ventricles). When deoxygenated blood comes back to the heart from the rest of the body, it goes into the right side, which is then sent to the lungs. The lungs remove the carbon dioxide during an exhale and replace it with oxygen during an inhale.
The inhaled oxygen goes back into the bloodstream, ready to be delivered to the tissues. The air then travels through the lungs to supply the left side of the heart with oxygen before distributing it to the entire body. With every breath, this cycle continues. The right side of the heart only pumps air to the lungs and is, therefore, weaker than the left side.
Pulmonary Hypertension and Coronary Obstructive Pulmonary Disease
One type of PH is associated with low oxygen levels and chronic lung problems. These cases fall into a category known as coronary obstructive pulmonary disease, or COPD. A person who has PH related to COPD may have difficulty breathing because the lungs do not expand with inhalations, making it difficult to get oxygen into airways. When air passages are obstructed, arteries in the lungs restrict, so blood only goes to the parts that get the most oxygen and air. The tightness causes high blood pressure in the lungs.
Symptoms of PH
Symptoms and signs of PH may not be noticed in its early stages, but they become more obvious as the disease progresses. They include the following:
- Shortness of breath
- Swelling in the legs and ankles
- Fainting or dizziness
- Pressure or pain in the chest
- Heart palpitations or irregular heartbeat
- Blue lips and skin
- Enlarged veins on the side of the neck
As the condition gets worse, it may also cause swelling in the abdomen.
Treating Pulmonary Hypertension
Three of the most common categories of medicine for treating PH are: vasodilators, to dilate blood vessels; calcium channel blockers, to lower blood pressure; and diuretics, to remove excess fluid and relieve pressure on the heart.
Vasodilators open blood vessels and allow blood to flow more easily. The price of vasodilators varies, depending on the specific brand and its availability as a generic. Oxygen and nitrous oxide are vasodilators, but so are Sildenafil and Tadalafil, more commonly known by the names Viagra and Cialis. Both start around $35 per pill with no discount or insurance.
Calcium channel blockers lower blood pressure by widening and relaxing blood vessels in the walls of arteries. They include older medications like Norvasc and Procardia, both of which can be purchased cheaply. Prices for other calcium channel blockers run from around $30 to $100 while prices for the most expensive ones, used to treat brain hemorrhages, can cost hundreds or thousands of dollars.
Diuretics, sometimes called water pills, help rid the body of excess water and sodium in the body’s tissues. Older forms of diuretics start out at less than $10 but can rise to several hundred for newer ones that are not available as generics.
Other Medications and Treatments
Digoxin – Digoxin is used to treat congestive heart failure and to help the heart pump more efficiently.
Coumadin or Warfarin – Coumadin and Warfarin are blood thinners used to keep the blood from clotting.
Oral – Certain oral medications help to keep the blood vessels from narrowing.
Inhaled – Certain inhaled treatments help to relieve shortness of breath.
Intravenous – Certain intravenous treatments help to keep blood vessels open and make breathing easier.
Subcutaneous – Subcutaneous treatments are delivered through a portable pump to relieve symptoms.
Clinical studies for new treatments, along with stem cell research, are currently being done find new or more effective ways to treat the symptoms of pulmonary hypertension and other lung disorders.