Nikolaos Panagiotopoulos

Pulmonary Artery Hypertension. Anatomy. Physiology. 

Pulmonary Artery  Hypertension. In order to understand the uncommon but very dangerous disease, we should know the heart anatomy. The heart although single can functionally be distinguished in two parts. Right and left heart. The right piece takes the body’s blood which is poor in oxygen. Through the pulmonary artery it pushes it into the lungs. It is enriched in oxygen and is driven by the pulmonary veins in the left heart. This sends the oxygen-rich blood to the whole body for its needs. So we have pulmonary or small circulation and large or systematic circulation.

 Secondary Pulmonary  Artery Hypertension. Causes

When pressure in systematic circulation increases, we are talking about the known to all of us hypertension. But when the pressure in the pulmonary vessels increases, then we are talking about pulmonary hypertension. But why the pressure in the pulmonary vessels increases? This can happen because the left heart has a serious problem, left heart failure due to valvular diseases, myocardial infarction, severe hypertension. So it can not send blood as a pump to the body with the power that is needed. The blood stays in the lungs and the pressure increases. Pulmonary hypertension. Someone has chronic lung disease. The lesions in the lungs affect the pulmonary vessels and increase their pressure. Pulmonary hypertension again. Obstruction of pulmonary vessels from thrombi called pulmonary embolism may also increase pulmonary stress. All these problems that reflect the increase in pulmonary pressure cause secondary pulmonary hypertension.

Primary Pulmonary Artery Hypertension

There is also primary pulmonary hypertension. There are cases where pulmonary pressure increases without apparent reason. The aetiology of the disease is attributed to local lesions of the pulmonary vessels and is unknown.

Pulmonary Artery Hypertension.  Symptoms

The symptoms are common. In the case of the secondary, of course, the symptoms of the left heart prevail. However, when pulmonary hypertension is induced, the symptoms are the same as those of right heart failure. Since the pressure in the pulmonary vessels is increased, the right heart, which is even more delicate, can not push blood vigorously. This builds up in the cervical vessels in the neck that inflate a lot. It concentrates on the liver that spreads, on the vessels of the abdomen and the vessels of the lower limbs. Therefore, shortness of breath from disturbed pulmonary circulation. Pain in the abdomen from the distension of the liver. Anorexia because the bowel does not work properly. Swelling in the legs. Weakness and fatigue because the heart can not properly feed the body with blood. The patient becomes disabled.

Diagnosis

The diagnosis is made initially with the clinical examination and continues with triplex of the heart. If increased pulmonary pressure is diagnosed , further testing is thorough. Special CT scans for blocking pulmonary embolism and indicating pulmonary disease. Check for coronary artery disease. Pulmonary control with spirometry and if necessary more specific examinations. All of this is valuable to the cardiologist for the correct assessment of the problem.

Treatment

Treatment depends on the cause. If pulmonary hypertension is secondary, we try to correct what caused it. At the same time, we treat it as the primary with diuretics, especially vasodilators and cardiological drugs. The treatment aims to improve the patient’s quality of life and extension. Regular monitoring is necessary and is combined with subtle interventions by the cardiologist. This requires knowledge and experience and is one of the most difficult issues in cardiology.

Cardiology office Marousi, Nikolaos Panagiotopoulos