What is pulmonary hypertension?

Pulmonary hypertension is a serious medical condition. It can lead to heart failure and requires specialist treatment. Pulmonary hypertension is not the same as common hypertension, which is high blood pressure.

What causes pulmonary hypertension?

Pulmonary hypertension is caused by damage, narrowing, blockage or other changes to the arteries in the lungs. These changes increase the pressure needed to keep the same amount of blood flowing to the lungs, forcing the heart to work harder. Left untreated, pulmonary hypertension can damage your heart.

Pulmonary hypertension can be caused by a range of problems, including:

• genetic problems
• some types of heart disease
• connective tissue diseases such as scleroderma
• blood clots in the lungs
• congenital heart disease
• lung diseases, such as pulmonary fibrosis, chronic obstructive pulmonary disease and sleep apnoea
• liver diseases
• chronic kidney failure
• HIV/AIDS

Read more here about the different forms of pulmonary hypertension.

What factors increase the risk of pulmonary hypertension?

Issues that can raise the risk of pulmonary hypertension include:

• a family history of pulmonary hypertension and certain other disorders
• obesity combined with obstructive sleep apnoea
• pregnancy
• living at high altitude
• certain toxins, medications or drugs
• smoking

What are the symptoms of pulmonary hypertension?

Pulmonary hypertension can develop slowly, and early warning signs might not be noticeable. Symptoms worsen as the disease progresses and the heart cannot keep up the flow of blood through the lungs.

The most common symptoms are:

• breathlessness, at first during exercise, and eventually when resting
• fatigue
• dizziness
• chest pain or chest pressure

Other signs include:

• fainting spells as well as dizziness
• heart palpitations or a racing pulse
• swelling in the ankles, legs and abdomen
• a bluish colour in the lips and skin
• rapid weight gain due to the build-up of fluid

How is pulmonary hypertension diagnosed?

If you have the signs of possible pulmonary hypertension, your doctor will examine you and ask about symptoms, medical conditions, medications, risk factors and family history.

Tests and procedures to diagnose pulmonary hypertension, as well as its cause and severity, include:

• an electrocardiogram (ECG)
• a chest x-ray
• an echocardiogram
• lung function testing
• a CT scan of your chest
• magnetic resonance imaging (MRI) of your chest
• pulmonary angiogram
• a walk test to measure exercise capacity
• sleep studies to measure oxygen levels
• blood tests

How is pulmonary hypertension treated?

If you are diagnosed with pulmonary hypertension, your doctor will talk to you about treatment options such as:

• medications
• oxygen therapy
• surgery or other procedures

Your doctor may also ask you to:

• eat a healthy diet
• quit, if you smoke
• reduce alcohol ;intake, if you drink
• get enough rest
• stay at a healthy weight

Living with pulmonary hypertension

The treatment of pulmonary hypertension can ease your symptoms and improve your quality of life. Your doctor may ask you to:

• weigh yourself daily, since gaining weight rapidly may be a sign your condition is getting worse
• stay as active as possible, while observing any restrictions advised by your doctor
• avoid birth control pills and getting pregnant
• avoid air travel or staying at high altitudes
• avoid situations that lower blood pressure, such as hot tubs, saunas and long baths
• get vaccines, as recommended by your doctor
• get medical advice before taking any other medicine

If you experience anxiety or stress living with pulmonary hypertension, ask for help. Support groups can help you to manage your situation.

Resources and support

More information about pulmonary hypertension and how to connect with others is available here:

• Pulmonary Hypertension Association Australia
• Pulmonary Hypertension Association (USA)