Pulmonary hypertension: symptoms and treatment. Treatment and signs of pulmonary hypertension Pulmonary pressure

In this article, you will learn: what is pulmonary hypertension. Causes of the development of the disease, types of increased pressure in vessels of the lung and how pathology manifests itself. Features of diagnosis, treatment and prognosis.

Article publication date: 07/01/2017

Article last updated: 05/29/2019

Pulmonary hypertension is a pathological condition in which there is a gradual increase in pressure in the pulmonary vascular system, which leads to increasing failure of the right ventricle and ultimately ends in premature death of a person.

With a disease in the circulatory system of the lungs, the following pathological changes occur:

In order for the blood to pass through the altered vessels, there is an increase in pressure in the trunk of the pulmonary artery. This leads to an increase in pressure in the cavity of the right ventricle and leads to a violation of its function.

Such changes in the blood flow manifest themselves as increasing respiratory failure in the early stages and severe heart failure in the final stages of the disease. From the very beginning, the inability to breathe normally imposes significant restrictions on the habitual life of patients, forcing them to limit themselves in exertion. Decreased resistance to physical labor worsens as the disease progresses.

Pulmonary hypertension is considered a very serious disease - without treatment, patients live less than 2 years, and most from this time they need help with personal care (cooking, cleaning the premises, buying groceries, etc.). With therapy, the prognosis improves somewhat, but it is impossible to completely recover from the disease.

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The problem of diagnosing, treating and monitoring people with pulmonary hypertension is dealt with by doctors of many specialties, depending on the cause of the development of the disease, these can be: general practitioners, pulmonologists, cardiologists, infectious disease specialists and geneticists. If surgical correction is needed, vascular and thoracic surgeons join.

Classification of pathology

Pulmonary hypertension is a primary, independent disease in only 6 cases per 1 million population, this form includes an uncaused and hereditary form of the disease. In other cases, changes in the vascular bed of the lungs are associated with any primary pathology of an organ or organ system.

On this basis, created clinical classification increase in pressure in the pulmonary artery system:

Main group	Disease subgroups
Pulmonary arterial hypertension	Idiopathic or no primary cause
	Familial (caused by mutations in certain genes)
	Associated with or associated with: vascular deposition of collagen (systemic lupus erythematosus, scleroderma); congenital heart defects; hepatic hypertension; HIV infection; drug or toxic damage; thyroid diseases; Goscher's disease (deposition in the tissues of glucocerebroside); Randu-Osler disease; glycogen storage disease; pathologies of the structure of the hemoglobin molecule (hemoglobinopathies); removal of the spleen; diseases accompanied by increased activity of the red bone marrow (myeloproliferative).
	Associated with a large lesion of capillaries and veins: pulmonary veno-occlusive disease (formation of blood clots in the venous system of the lungs), pulmonary capillary hemangiomatosis (proliferation of tissue of small vessels with the formation of benign formations - hemangiomas).
	Persistent (long-term) pulmonary hypertension of the newborn
Pulmonary hypertension associated with left heart disease	Left ventricular injury
Pulmonary hypertension associated with left heart disease	Left ventricular valve disease
Hypertension associated with diseases of the respiratory system and/or low blood oxygen	Violation of the development of the lungs (hereditary and congenital forms of underdevelopment)
	Alpine (associated with low air pressure in the mountains)
	Pathology of breathing during sleep (sleep apnea syndrome)
	Violation of the function of the alveoli - the main active units of lung tissue
	Chronic obstructive pulmonary disease
	Damage to the intercellular space of the lung tissue (interstitium) - inflammation, proliferation of connective tissue
Pulmonary hypertension in the background or embolism	Blockage of the terminal branches of the pulmonary arteries
	Overlapping of the lumen of the initial branches of the vessels
	Non-clot related thrombosis:
mixed forms	Sarcoidosis - the formation of connective tissue granulomas in the lung tissue
	Histiocytosis - the formation of foci of accumulation of histiocytes in the lungs
	Lymphangiomatosis - benign tumors lymphatic vessels
	Compression of the pulmonary vessels from the outside: an increase in intrathoracic lymph nodes (lymphadenopathy); inflammation of the mediastinum (mediastinitis).

An increase in pressure in the circulatory system of the lungs due to a violation of the structure of the heart is noted with defects associated with discharge arterial blood into the venous system: septal defects between the atria and ventricles, open ductus arteriosus.

Causes and risk factors for development

The following causes can influence the increase in pressure in the pulmonary arteries:

Manifestations of pathology, classes of the disease

The primary stage of changes in the vascular system of the lungs proceeds imperceptibly - compensatory, substitution mechanisms cope with the pathology that has arisen, and this is enough for the patient's normal state.

When the level of average pressure in the pulmonary artery reaches a critical value of 25–30 mm Hg. Art. the first symptoms of pulmonary hypertension appear. At this stage, the sick person experiences deterioration only with physical overstrain and lives a full life.

As changes in the vessels progress, tolerance to stress decreases, as a result, even household chores may require outside help.

Symptoms of the disease	Their characteristic features
Dyspnea	Difficulty occurs only when inhaling The first manifestation of pathology Initially occurs only during exercise In later stages present at rest No asthma attacks
Chest pain	Can be anything: aching, squeezing, stabbing or pressing No clear onset of pain syndrome Duration from a few seconds to a day Enhanced by physical exertion No effect from taking Nitroglycerin
Dizziness, fainting	Always connected to the load Duration from 2–5 to 20–25 minutes
Interruptions in the work of the heart, palpitations	ECG records sinus tachycardia
Cough	Occurs in 1/3 of patients In most cases, dry (if there is no concomitant disease of the respiratory system)
Blood in sputum (hemoptysis)	Only 10% of patients have Occurs once Rarely persists for several days Associated with the formation of clots in small vessels

In order to assess the severity of the disease, depending on the severity of manifestations, use the division of pulmonary hypertension into classes.

Diagnostics

Having determined what kind of disease pulmonary hypertension is, how it manifests itself and why it occurs, you can proceed to the features of the diagnosis. The table shows the methods of examining the patient and the pathological changes that are characteristic of an increase in pressure in the circulatory system of the lungs. Signs of the disease that caused the pathology (if any) are not indicated in this article.

Diagnostic method	What changes can be seen
Initial examination of the patient	Blueness of the skin on the arms and legs (acrocyanosis) Change in the shape of the fingertips and nails (thickening, expansion of the " drumsticks" and "watch glasses") Increase in chest size in patients with emphysema ("barrel") Liver enlargement (hepatomegaly) Accumulation of fluid in the cavities of the abdomen and chest (ascites, pleurisy) Edema on the legs Enlargement and swelling of the veins in the neck
Auscultation or listening to the lungs and heart	Amplification 2 tone over the pulmonary artery Systolic murmur of valve insufficiency between the right atrium and ventricle Dry, single wheezing over the surface of the lungs Other murmurs characteristic of heart disease, if it is the cause of the pathology
ECG (electrocardiography) - effective in 55%.	Thickening and expansion of the right ventricle (hypertrophy and dilatation) - detected in 87% of patients Signs of overload of the right heart - present in less than 60% of cases Deviation of the electrical axis of the heart to the right - in 79%
VCG (vectorelectrocardiography) - assessment of the cardiac cycle is not on the line (ECG), but on the plane. Effective at 63%.	The same changes as on the ECG
FKG (phonocardiography) - registration of noise that occurs during the work of the myocardium. Diagnostic efficiency increases up to 76–81%	The initial stage of increasing pressure in the pulmonary artery Primary changes in the structure of the right ventricle before the addition of a decrease in its function Stagnation of blood in the pulmonary circulation Change in tricuspid valve function Diagnosis of malformations of the heart muscle
Chest x-ray	Bulging of the pulmonary artery Expansion of the roots of the lungs Enlargement of the right parts of the heart muscle High transparency along the edge of the lung tissue
(ultrasonography) through the chest	Increased pressure in the trunk of the pulmonary artery Degree of tricuspid valve insufficiency Paradoxical movement of the interventricular septum (with contraction it deviates into the cavity of the right ventricle) The presence of heart defects with the discharge of blood into the venous system Expansion of the cavities of the right sections of the heart muscle Thickening of the anterior wall of the right ventricle
Right heart catheterization is an invasive procedure for inserting a transducer into the heart through a system of large veins.	Accurate numbers of increased pressure in the trunk of the pulmonary artery, ventricular cavity Change in the volume of blood flowing from the ventricle into the artery during myocardial contraction Increased vascular resistance in the pulmonary circulation Oxygen saturation level of arterial and venous blood
Carrying out drug tests during cardiac catheterization	Reaction to the administration of calcium antagonists (essential drugs for treatment)

Additional research methods

They are used to clarify the cause of an increase in pressure in the pulmonary artery system and to conduct a clarifying diagnosis, if there is no certainty in the exact disease. These studies are also needed to establish the clinical class of pulmonary hypertension.

FVD (function external respiration). It is necessary to evaluate to exclude the pathology of the respiratory system. With increased pressure in the circulatory system of the lungs, a moderate decrease in the partial pressure of oxygen and carbon monoxide (the main blood gases) is noted.
Ventilation-perfusion lung scintigraphy is a study of the lungs by introducing radioactive particles into the blood. It is carried out to exclude blockage by clots of the branches of the arteries of the lungs, as the main cause of breathing problems.
MSCT (multispiral computed tomography) of the heart and lungs with contrast enhancement is an X-ray method for creating a three-dimensional image of an organ using a computer program. It allows you to accurately determine the cause of the increase in pressure, if it is associated with the cardiovascular or respiratory systems, as well as to assess the degree of dysfunction of the heart muscle and the level of replacement of the connective tissue of the vessels of the lungs.
APG (angiopulmonography) - the introduction of a contrast agent into the vessels of the lungs and the fixation of the resulting image using X-rays. Indicated for suspected thromboembolism, which could not be detected in other studies.

Treatment Methods

Any methods of treatment of pulmonary hypertension give only a temporary effect. It is impossible to completely rid the patient of the disease, regardless of the cause of the increase in pressure in the vessels of the lungs. With a good response to treatment, the general condition of the patient improves, the ability to perform physical activity and life expectancy more than doubles. If the pathology is not treated, then death occurs within 2 years after the detection of the disease.

to avoid physical activity after eating and under adverse temperature conditions (very hot or cold);
perform daily dosed physical exercises that do not cause symptoms and maintain good vascular tone;
use oxygen therapy during air travel;
avoid and prevent inflammatory diseases bronchi and lungs;
do not use hormone replacement therapy in menopause;
if possible, refrain from pregnancy and childbirth;
do not use hormonal methods of contraception;
prevent a decrease in hemoglobin levels (anemia).

Medications

Drug therapy is the main way to correct pulmonary hypertension. In the treatment, several groups of drugs are used, most often in combination with each other.

1. Basic treatment - the patient receives the medicine on an ongoing basis

2. Course treatment - use several times a year or as needed

Oxygen therapy is a highly effective way to increase the level of blood saturation when the condition worsens or in adverse environmental conditions.

Nitric oxide - has a high vasodilating effect, is used for inhalation for several hours only during hospitalization.

Surgical treatments

It is used in case of low efficiency of the ongoing medical treatment and with malformations of the heart muscle.

Method	When to use
Atrial septostomy - creating a message between the atria	With severe insufficiency of the function of the right ventricle, as a preparatory stage before and lungs
Thrombendarterectomy - removal of blood clots from the arteries	Remove clots from primary departments branches of the pulmonary artery to reduce the load on the right ventricle and reduce the manifestations of heart failure. It can be done only if the thrombus has not begun to degenerate into connective tissue (the first 5-10 days)
Heart or lung-heart transplant	Carried out in patients with primary, idiopathic pulmonary hypertension in the last stage of heart failure With severe heart defects that caused impaired blood flow in the lungs

Forecast

Once diagnosed with pulmonary hypertension, the prognosis for complete recovery is poor. The life span of patients, even with treatment, is limited. In any form of the disease, there is a rapid or slow increase in the insufficiency of the work of the right half of the heart muscle, against which the death of the sick person occurs.

The most unfavorable course is pulmonary hypertension against the background of systemic scleroderma (degeneration of organ cells into connective tissue) - patients live no more than a year.
The prognosis for the primary form of increased pressure in the blood vessels of the lungs is slightly better: average term life - up to 3 years.
Development of the heart and lung failure with malformations of the heart - an indication for surgical treatment(transplantation of organs). 40–44% of such patients survive the five-year term.
An extremely unfavorable factor is the rapid increase in the insufficiency of the right ventricular function and its extreme forms of manifestation. Treatment in such cases does not work, the diseased die within 2 years.
With a good response to the ongoing medicinal treatment(with a "mild" form of pulmonary hypertension), more than 67% of patients survive the five-year period.

Many people have heard about arterial hypertension - this is the name of hypertension. But less is known about pulmonary hypertension - it belongs to rare diseases, occurs in about 5 people out of 100 thousand. How the disease manifests itself, what effective methods used in therapy?

Causes and forms of pathology

Pulmonary arterial hypertension - what is it? This is the name of the disease caused by pathological changes in the pulmonary system, in which there is a sharp increase in intravascular pressure above 35 mm Hg. Art.

Primary pulmonary hypertension is not a fully understood form of the disease. The reason for the development of the idiopathic form of pathology is genetic disorders of the vessels of the pulmonary system. In the body, substances are produced in small quantities that are responsible for the expansion and narrowing of blood vessels. Primary hypertension can be caused by excessive platelet activity, which leads to vascular occlusion.

Secondary pulmonary hypertension develops as a result of various chronic diseases - congenital heart disease, thrombotic lesions of the artery in the lungs, Pickwick's syndrome, cardiological and pulmonary diseases, bronchial asthma.

Chronic thromboembolic pulmonary hypertension is caused by blockage of blood vessels. The disease is characterized by rapid progression, acute respiratory failure, decreased blood pressure, hypoxia.

Factors contributing to the development of the disease:

taking amphetamines, cocaine, antidepressants and appetite suppressants;
pregnancy, hypertension, HIV, pathological changes in the liver;
oncological diseases of the hematopoietic system;
increased pressure in the collar zone;
hyperthyroidism;
frequent climbs in the mountains;
compression of blood vessels in the lungs by a tumor, a deformed sternum, or due to obesity.

Important! Studies by foreign scientists have proven that some antibiotics, hormonal oral contraceptives cause primary pulmonary hypertension. Pathology often develops in smokers.

How the disease manifests itself

Moderate pulmonary hypertension develops slowly, at the initial stage, the symptoms of the disease do not have a pronounced manifestation. Main clinical sign diseases - cor pulmonale. Pathology is characterized by hypertrophic changes in the right parts of the heart.

What symptoms should you see a doctor for:

The main manifestation of the disease is shortness of breath, which increases even with minor physical exertion.
Heart palpitations. The cause of tachycardia is respiratory failure, lack of oxygen in the blood.
Pain syndrome. Pain of a compressive nature occurs behind the sternum and in the region of the heart. With strong physical exertion, fainting is possible.
Dizziness, weakness, fatigue.
Accumulation of fluid in the peritoneum (ascites), severe swelling and blue discoloration of the extremities, bulging of the veins in the neck. These symptoms develop against the background of chronic right ventricular failure - the heart muscle of the right ventricle cannot cope with the load, which leads to disturbances in the systemic circulation.
Enlargement of the liver leads to heaviness and pain under the right ribs.
Nausea, flatulence, vomiting are caused by the accumulation of gases in the intestines. Weight loss with a normal nutritious diet.

The fingers thicken in the upper phalanges, the nails become like watch glasses. As the pathology develops, sputum appears with an admixture of blood, which signals the onset of pulmonary edema. The patient suffers from attacks of angina pectoris and arrhythmias. At terminal stage disease begins the death of active tissues.

Important! Pulmonary hypertension is a hereditary disease caused by a defect in the genome.

Degrees of the disease

Depending on the degree of development of the cor pulmonale and hypoxia, 3 degrees of pathology are distinguished.

Pulmonary hypertension 1 degree. In the transient form, there are no clinical and radiological manifestations. At this stage, there may be primary symptoms respiratory failure.

Pulmonary hypertension grade 2. At a stable stage of the disease, shortness of breath begins to develop and cor pulmonale begins to form. When listening, you can hear the initial manifestations of increased pressure in the pulmonary artery.

At the third stage, the liver enlarges, puffiness appears, the skin changes color, the veins in the neck begin to swell strongly.

Diagnostics

Signs of pulmonary hypertension are often not very specific, therefore, based only on complaints and external examination it is difficult to correctly establish the underlying cause of the disease. Only with the help of a thorough diagnosis can you see all the pathologies and failures in the body. You need to consult a pulmonologist and a cardiologist.

How is the diagnosis carried out:

Taking an anamnesis - determining, from the words of the patient, the time of deterioration of the condition, how the disease manifests itself, which may be associated with the appearance of unpleasant symptoms.
Lifestyle analysis - the presence of bad habits, hereditary diseases, working conditions.
Visual inspection - blue skin, changing the shape of the fingers and the condition of the nails. The doctor notes if there is swelling, a change in the size of the liver. Be sure to carefully listen to the lungs and heart with a phonendoscope.
ECG - with its help determine changes in the size of the right heart.
A chest x-ray allows you to see an increase in the size of the heart.
Catheterization (pressure measurement) of an artery.

The most informative type of diagnosis is echocardiography. Signs of pulmonary hypertension on ultrasound of the heart are manifested in the form of right ventricular hypertrophy. Indicators less than 4 mm indicate the absence of pathology. If the wall thickness of the ventricle exceeds 10 mm, this indicates the development of pulmonary hypertension.

Conservative treatments

After a thorough diagnosis, medical treatment should be started immediately. The goal of therapy is to eliminate or correct the main manifestations of the disease, to prevent the development of concomitant diseases.

Drugs of choice for pulmonary hypertension:

Calcium channel blockers - Prazosin, Nifedipine. These medicines are prescribed for early stage diseases. Verapamil is not recommended for the treatment of hypertension, since the therapeutic effect of the drug is rather weak.
Drugs that thin the blood - Aspirin, Cardiomagnyl.
Diuretics - Lasix, Furosemide.
Digoxin is a cardiac glycoside. The drug is indicated for atrial fibrillation to normalize the heart rhythm.
Anticoagulants - Warfarin, Heparin. Medicines are used to prevent blood clots.
Prostaglandins and their analogues - Treprostinil, Epoprostenol. Medicines to normalize pressure in the pulmonary artery.
Bosentan - slows down the development of pulmonary hypertension.
Drugs that improve metabolic processes in cells - Riboxin, Potassium Orotat.

For several years, scientists have been conducting a study on the effectiveness of the use of Sildenafil in the complex therapy of pulmonary hypertension. Sildenafil citrate is the main component of Viagra and is designed to eliminate erectile dysfunction.

The drug was used on patients for 12 weeks. In control groups who received 20–80 mg medicinal product, scores have improved significantly.

How to treat in adults

If the patient's hemoglobin level exceeds 170 g / l, the neck veins bulge out - bloodletting is performed. Positive results are given by oxygen inhalations, which must be done in courses.

It is possible to reduce the progression of the disease with the help of surgery. The bypass method is used - an artificial oval window is created between the atria, due to which high pulmonary hypertension decreases. This allows you to prolong the life of the patient, the prognosis of the course of the disease is significantly improved.

Organ transplantation is also used - to eliminate the pathology, it is enough to transplant 1 lung. But after 5 years, many patients begin rejection.

Important! In the later stages of the disease, a heart and lung transplant is possible. It is not advisable to carry out such an operation at the beginning of the development of pathology.

This pathology indicates the inability to adapt to the blood circulation in the lungs outside the womb and occurs in 0.1–0.2% of newborns. Most often, the disease is diagnosed in children who were born by caesarean section. Identification of the disease occurs in the first 3 days after birth.

Against the background of hypertension, the pressure in the vessels of the lungs begins to rise sharply, the heart experiences increased stress. To avoid heart failure, the body begins to reduce pressure in the lungs - reduces the volume of circulating blood, dumps it into the oval window in the heart or into an open arterial stream. Such actions lead to an increase in venous blood, a decrease in oxygen content.

Reasons for the development of pathology:

transferred prenatal stress - hypoxia and glycemia can cause a spasm in the pulmonary artery in the newborn, as well as sclerotic changes in the walls of the vessel;
maturation delay vascular walls- spasms often occur in such vessels;
the presence of congenital diaphragmatic hernia- with such a disease, the lungs and blood vessels remain underdeveloped and cannot function in full;
premature closure of the embryonic arterial duct, which leads to an increase in pulmonary blood flow;
congenital cardiac and pulmonary malformations.

Hypertension in a newborn may occur against the background of intrauterine infection, sepsis. The cause may be polycythemia - an oncological disease in which the number of red blood cells increases sharply.

Important! Some medications that a woman took during pregnancy - antibiotics, aspirin - can cause pathology in a child.

In a newborn with pulmonary hypertension, breathing is heavy, shortness of breath begins, on inspiration the chest falls inward, the skin and mucous membranes turn blue. Without timely qualified assistance, 4 out of 5 babies with pathologies die within the first three days after birth.

Pathology during pregnancy

Important! Pulmonary hypertension is diagnosed in women of childbearing age almost 2 times more often than in men.

The cause of the development of the disease during pregnancy can be a heart disease, a genetic predisposition to hypertension.

The first signs of the disease in pregnant women:

the appearance of shortness of breath even at rest;
cough of unproductive origin;
weakness and fatigue;
frequent respiratory diseases.

Appear in the second and third trimester pain in the region of the heart and sternum, moist rales in the lungs, swelling. In the absence of the necessary therapy, spontaneous abortion is possible.

Women who have pathologies of the pulmonary vessels are advised to avoid pregnancy. If pregnancy is interrupted, the risk of death is 7%. If a woman does not want to terminate the pregnancy, then she will have to spend all the time before the baby appears in the hospital. The hospital will carry out oxygen therapy, prevention of blood clots.

The mortality rate among women in labor is very high (up to 40%), regardless of the therapy carried out during pregnancy. Most deaths occur directly during delivery or in the first week after delivery.

Folk methods of treatment

Even traditional medicine is not able to completely eliminate pulmonary hypertension. Therapy will be effective only if the cause of the disease can be eliminated. Treatment with folk remedies is aimed at reducing symptoms.

Brew 225 ml of boiling water 5 g of ripe mountain ash, leave for an hour. Take 110 ml three times a day. The duration of therapy is 1 month.
You can get rid of arrhythmias with fresh pumpkin juice. You need to drink 100 ml of the drink per day.
Also, for treatment and prevention, you need to eat 4 juniper berries daily. You can also make an infusion from them. Pour 25 g of fruits into a thermos, pour 260 ml of boiling water, leave overnight. Divide the medicine into 4 servings, drink in 1 day.
Adonis helps to eliminate the main manifestations of the disease, relieves pulmonary edema. Brew 220 ml of boiling water 3 g of raw materials, leave for 2 hours. Take 30 ml before meals.

Garlic

Peel and chop 2 fresh heads of garlic, put the mixture in a glass container, pour 230 ml of vodka. Insist 15 days in a dark, cool room. Take tincture 5 times a day. A single dose is 20 drops - the medicine must be diluted in 15 ml warm water or milk. The duration of therapy is 21 days.

For alcohol intolerance, a medicine is made from 3 large heads of garlic and 3 crushed lemons. Pour the mixture into 1 liter of boiling water, close the container, leave for a day. Take 3 times a day, 15 ml.

Herbs

Alcohol tincture is prepared from calendula inflorescences. Pour 160 ml of vodka 60 g of raw materials, leave for a week. Take 25 drops three times a day for 3 months.

Here are more recipes:

Grind 22 g of dried birch leaves, pour 420 ml of boiling water, put in a dark, cool room for 2 hours. Take 105 ml four times a day. The duration of treatment is 15 days.
Brew 245 ml of boiling water 6 g of toad grass, leave for an hour in a closed container. Take 35 ml 36 times a day.
Grind the corn silk into powder. Add 100 ml of fresh honey to 50 g of powder, take the medicine 5 g before meals 3-5 times a day.

Important! Non-traditional methods treatment must be used only in combination with drugs.

Nutrition rules

Diet for pulmonary hypertension implies a restriction in the diet of salt, animal fats. It is also necessary to reduce the amount of fluid consumed. The basis of nutrition should be plant foods, animal products should be with a minimum amount of fat.

Lifestyle:

exacerbation prevention autoimmune diseases- timely vaccination against influenza, rubella, other infectious diseases;
dosed physical activity early stages diseases are prescribed physiotherapy exercises, at the last stage, physical activities are minimized or completely limited;
protection against pregnancy increased load on the heart with pulmonary hypertension can lead to lethal outcome;
consultations with a psychologist to restore neuropsychic balance - patients with hypertension often experience depressive states, suicidal thoughts.

To prevent the development of the disease, all bad habits must be eliminated. With regular physical activity, blood circulation improves, which prevents the formation of blood clots. The diet should be complete and balanced.

Predictions and consequences

Without proper treatment, the average life expectancy for pulmonary hypertension is 2.5 years. The disease from the primary stage passes into the secondary, the signs of the disease are aggravated, the condition worsens noticeably.

Against the background of inadequate tissue oxygen supply, severe and frequent shortness of breath develops, which occurs even in a calm state. Hypoxia leads to an increase in blood viscosity - blood clots occur, which can clog the vessels in the lungs.

Mean pulmonary artery pressure is an important factor in life expectancy. If the indicators are consistently above 30 mm Hg. Art. and do not decrease under the influence medications- life expectancy will be about 5 years.

Important! Positive forecasts can be made if therapy with calcium channel blockers leads to an improvement in the patient's condition, the signs of the disease gradually recede. In this case, only 5% of patients live less than 5 years.

Pulmonary hypertension often leads to disability. With such a disease, many types and working conditions are contraindicated - hard physical labor, mental work with high nervous overload and strong speech load. People with this diagnosis are forbidden to work in rooms with high humidity, strong temperature and pressure drops.

With pulmonary hypoxia, it is impossible to work in hazardous production - dust, irritating gases, poisons and other allergens can worsen the patient's condition.

Disability

Is there a disability for pulmonary hypertension? Yes, you need to go through a special commission to get it. From the documents you need to provide:

chest x-ray;
spirography;
results of the acid-base state of the blood and blood gases;
echocardiography.

What disability group can be assigned for pulmonary hypertension? With a highly progressive underlying disease that causes a limitation of the patient's ability and the inability to serve himself independently, the inability to move is determined by disability of the 1st degree.

If unstable or slight improvements are observed during therapy, the patient has limitations in self-care and movement, a II disability group is assigned. Sometimes the patient is recommended to work at home or in specially created conditions.

When determining the III group of disability, a person can engage in light physical labor even in industrial conditions, mental work with moderate mental and emotional overload.

The disease code for primary pulmonary hypertension in the international classification of diseases (ICD 10) is 127. Secondary - 128.8.

Pulmonary hypertension is a serious disease with a high mortality rate. You can avoid the disease by giving up bad habits and timely consultations with doctors, even with a slight deterioration in health.

A pathological condition, the course of which is characterized by an increase in pressure in the pulmonary artery, is called pulmonary hypertension in medicine. In terms of frequency, the disease ranks third worldwide among vascular diseases characteristic of the elderly.

Causes of Pulmonary Hypertension

Pulmonary hypertension may be congenital anomaly, that is, primary, or acquired, which is called secondary.

The following factors may be the reason for the increase in pressure in the arteries of the lungs:

heart failure;
vasculitis;
heart defects of various origins;
chronic lung diseases, including tuberculosis, bronchial asthma, etc.;
PE or other lesions of the pulmonary vessels;
metabolic disorders;
location in high mountain regions.

In cases where it is not possible to determine the exact causes of hypertension, the doctor makes the diagnosis of primary hypertension. As a disease state of unknown origin, primary pulmonary hypertension may be triggered by various means contraception or result from an autoimmune disease.

Secondary lung disease can be caused by pathologies of the heart muscle, lungs or blood vessels.

Disease classification

Depending on the severity of the course of the disease state, physicians distinguish 4 classes of patients:

The first stage, not accompanied by loss of physical activity. A patient with pulmonary insufficiency can withstand normal activities without the appearance of weakness, dizziness, chest pain or shortness of breath.
At the second stage diseases physical activity patient is limited. At rest, there are no complaints, but the usual load causes severe shortness of breath, dizziness and severe weakness.
Third stage of hypertension causes the above symptoms with the slightest physical activity of a person suffering from this disease.
Pulmonary hypertension stage IV marks pronounced signs weakness, shortness of breath and pain even when a person is in a state of absolute rest.

Symptoms of lung failure

The main symptom of the disease is shortness of breath, which has several specific features that make it possible to distinguish it from the symptoms of other diseases:

schematic structure of the vessels of the lungs

observed at rest;
its intensity increases with minimal physical activity;
in a sitting position, shortness of breath does not stop, unlike shortness of breath of cardiac origin.

Other signs of pulmonary hypertension are also characteristic of most patients:

weakness and fatigue;
persistent dry cough;
swelling of the legs;
pain in the liver area caused by its enlargement;
pain in the sternum due to the fact that the pulmonary artery expands;
in some cases, a hoarse voice is observed. This is due to the fact that the artery, when expanded, infringes on the laryngeal nerve.

Thus, pulmonary hypertension, the symptoms of which are often not specific, does not always allow a correct diagnosis to be made without a whole range of examinations.

Diagnosis of the disease

As a rule, patients come to doctors with complaints of severe shortness of breath, which interferes with their ordinary life. Since primary pulmonary hypertension does not have specific symptoms, allowing you to make a diagnosis with confidence at the first visit to the doctor, the diagnosis should be carried out with the participation of a cardiologist and a pulmonologist.

The complex of procedures involved in the process of making a diagnosis includes the following methods:

medical examination and history taking. Often the disease has hereditary causes, so it is extremely important to collect information about family ailments;
clarification of the current lifestyle of the patient. Smoking, not exercising, taking various medicines- all this is important in finding out the causes of shortness of breath;
general inspection. On it, the doctor has the opportunity to identify the physical condition of the veins in the neck, skin color (blue in case of hypertension), enlargement of the liver, the occurrence of edema in the legs, thickening of the fingers;
electrocardiogram. The procedure allows you to identify changes in the right side of the heart;
echocardiography helps to determine the speed of blood flow and general condition vessels;
will show, using a layered image, an increase in the pulmonary artery, as well as possible concomitant ailments of the lungs and heart;
radiography of the lungs will allow you to observe the condition of the artery, its expansion and narrowing;
the catheterization method is used to reliably measure the pressure inside the pulmonary artery. Doctors consider this procedure not only the most informative for obtaining pressure values, but also associated with minimal risks of complications;
the 6-minute walk test helps determine the patient's physical response to stress and establish the class of hypertension;
blood test: biochemical and general;
angiopulmonography allows, by introducing a special contrast agent into the vessels, to obtain full drawing vessels in the pulmonary artery. The method must be used with extreme caution, since its use can provoke a hypertensive crisis in the patient.

Thus, pulmonary hypertension should be diagnosed only after a thorough comprehensive study of the patient's vascular condition in order to exclude an erroneous diagnosis.

Reason to see a doctor

The patient should consult a doctor if he feels the following signs of malaise:

the occurrence or increase in shortness of breath when performing normal daily activities;
the appearance of pain of undiagnosed origin in the chest;
if the patient has an inexplicable and persistent feeling of fatigue;
the appearance or increase in the degree of swelling.

Treatment of pulmonary insufficiency

In most cases, primary pulmonary hypertension is treatable. The main guidelines for choosing a treatment method are:

identification and elimination of the cause of the patient's condition;
decrease in pressure in the artery of the lung;
preventing the formation of blood clots in the patient's vascular system.

When prescribing treatment, the doctor may prescribe the following drugs:

medicines that act relaxing on the muscular layer of blood vessels. This group of drugs is very effective in the initial stages of the disease. Pulmonary hypertension, the treatment of which was started even before the vascular changes become pronounced and irreversible, has a very good chance of completely getting rid of the patient's symptoms;
medicines designed to lower the viscosity of the blood. If the blood clotting is very severe, the doctor may decide to bleed. The hemoglobin level in such patients should not exceed 170 g/l;
with severe shortness of breath and hypoxia, oxygen inhalations are indicated as a means of relieving unpleasant physiological symptoms;
your doctor may recommend reducing your salt intake and reducing your fluid intake to one and a half liters clean water in a day;
a strict ban on intense physical activity. Only such activity is allowed in which the patient does not feel discomfort and painful manifestations;
if pulmonary hypertension is accompanied by a complication in the form of insufficiency of the right ventricle of the heart, the doctor prescribes regular intake of diuretic drugs;
in the most advanced cases of the disease, they resort to a heart and lung transplant procedure. The technique has not yet been sufficiently developed in practical conditions, but the statistics of such transplantations testify to their effectiveness.

Possible Complications

Among the negative consequences of the disease, the main ones can be distinguished:

exacerbation of heart failure. The right parts of the heart can no longer cope with their current load, which further worsens the patient's situation;
a condition called PE is a thrombosis of an artery in the lung when a blood clot blocks a vessel. This disease is not only dangerous, but directly threatens the life of the patient;
associated with pulmonary edema.

As a rule, the disease significantly reduces the patient's standard of living and in most cases leads to premature death.

However, pulmonary hypertension causes chronic or acute form heart and lung failure, life-threatening patient.

Prevention

In order to reduce the risk of this disease has become minimal, the following measures must be taken:

adhere to the principles of a healthy lifestyle. In particular, it is necessary to categorically give up smoking and do physical exercises daily;
it is necessary to timely identify and treat the underlying diseases that entail hypertension. This is possible with regular preventive visit doctor;
with established diseases of the bronchi and lungs of a chronic nature, you need to carefully monitor the course of the disease. Dispensary observation will avoid complications of the disease and facilitate its course;
diagnosed pulmonary hypertension is not a ban on any physical activity. On the contrary, such patients are shown a moderate exercise in the fresh air. Activity should be regular, but never more intense;
all situations that entail a stressful state must be excluded. Conflicts at work, at home or in transport can exacerbate the disease.

Thus, the sooner the patient turns to the doctor for advice and the more carefully he follows his instructions, the more likely it is to stop the course of the disease and not transfer it to a more severe stage that is less treatable.

Pulmonary hypertension (PH) is a disease in which pressure in the pulmonary artery increases. Normally, systolic pressure in the pulmonary circulation should be 18-25 mm Hg, diastolic - 6-10 mm Hg, and the average specific pressure - within 12-16 mm Hg. The diagnosis of "pulmonary hypertension" is made if the average specific pressure exceeds 30 mm Hg. during physical activity and 25 mm Hg. at rest.

This disease significantly worsens the patient's condition and has an unfavorable prognosis.. In some cases, it develops slowly, so patients may not be aware that they have pulmonary hypertension for a long time and start treatment at a late stage. But remember that in any case, not all is lost: if you have been diagnosed with this disease, you can improve your condition thanks to special folk remedies. They reduce pressure in the pulmonary artery and relieve unpleasant symptoms.

Stages of pulmonary hypertension

So, we know what LH is, now it's time to talk about its stages. Based on the pressure measured in the pulmonary artery, the disease is divided into three groups:

mild pulmonary hypertension - corresponds to an average specific pressure of 25-36 mm Hg;
moderate pulmonary hypertension - pressure is 35-45 mm Hg;
severe pulmonary hypertension - pressure exceeds 45 mm Hg.

Naturally, the higher the severity of the disease, the worse its prognosis.

Causes and types of pulmonary hypertension

The cause of PH is a steady increase in pressure in the pulmonary vessels. This may be due to the following factors:

heart disease, valvular disease (mitral regurgitation) or Eisenmenger's syndrome with congenital anomalies;
lung diseases such as pneumoconiosis (COPD), sleep apnea syndrome sleep;
connective tissue diseases such as systemic lupus erythematosus, etc.;
complications after pulmonary embolism;
other diseases that damage the pulmonary vessels (HIV infection, portal hypertension, poisoning with toxic drugs).

Pulmonary hypertension in terms of causes of occurrence is divided into 4 groups:

pulmonary arterial hypertension - mainly caused by connective tissue diseases, HIV - infection, portal hypertension, heart defects;
venous pulmonary hypertension - develops as a result of diseases of the left valve or left ventricle of the heart;
pulmonary hypertension associated with respiratory diseases or hypoxia - mainly appears due to interstitial lung disease, COPD, breathing disorders during sleep, chronic mountain sickness;
pulmonary hypertension associated with chronic thromboembolism - caused by blockage of the pulmonary arteries.

Primary pulmonary hypertension

The primary form is also sometimes referred to as idiopathic pulmonary hypertension. It occurs rarely (about 2 cases per million people), its etiology is unknown. The disease is more often diagnosed in middle-aged women. Risk factors, in addition to the above, are a family history of hypertension, infectious diseases and portal hypertension.

Primary pulmonary hypertension occurs with vasospasm in the pulmonary circulation. In this case, excessive blood clotting is observed. The prognosis is very unfavorable. However, if you have been diagnosed with primary pulmonary hypertension, do not despair. Better pull yourself together and start treatment with folk remedies - this will help prolong life for many years.

Secondary pulmonary hypertension

It develops against the background of other diseases - bronchial asthma, heart defects, pulmonary fibrosis, hypertension, systemic lupus erythematosus, etc. Thus, in order to get rid of PH, you must first cure the primary disease, if possible.

Symptoms

The first signs of pulmonary hypertension are a feeling of continuous fatigue and difficulty breathing, especially after exercise. Patients have difficulty walking, climbing stairs, bending over, and doing normal housework.

In the later stages of the disease, the following symptoms appear:

dry cough;
hoarseness;
chest pain;
hemoptysis;
bluish tint of lips;
fainting;
cold extremities.

Pulmonary hypertension in newborns is manifested by retraction of pliable places on the chest, shortness of breath and severe cyanosis of the skin. In this case, oxygen treatment does not give any results.

Forecast and consequences

Any kind of PH gives the same result: increased pulmonary vascular resistance. These conditions force the right ventricle to work harder, resulting in cardiac hypertrophy and dilatation within the right ventricle. As a result, congestive heart failure and mitral valve insufficiency develop. Excessive overload of the right ventricle due to lung disease is called cor pulmonale. These changes lead to a decrease in cardiac output, and if the disease is not treated, then to death.
The prognosis depends on the neglect of PH. If you take care of yourself, follow some recommendations and carry out treatment, you can stop the development of the disease.

Treatment

So, you already know what pulmonary hypertension is and what are its symptoms. Now it's time to consider treatment.

Palliative care if you have idiopathic (primary) pulmonary hypertension, which allows you to extend the life of the patient and improve its quality. With secondary pulmonary hypertension, the diseases that led to such a problem are eliminated.

Below we will give lifestyle advice to patients and present folk remedies that reduce pressure in the pulmonary artery.

Diet and lifestyle

Patients should avoid situations in which the symptoms of the disease worsen. Give up physical effort, do not climb to great heights, do not fly in airplanes. If the state of health deteriorates, breathing through oxygen cylinders can be used.

It is very important to try to avoid stress, as it increases blood pressure and heart rate. To combat stress, use meditation, walking in the fresh air, meeting friends, hobbies, and other appropriate ways.

When it comes to diet, the main rule here is to reduce salt intake. Replace it with other spices. Also, patients should drink no more than 1.5 liters of water per day, so as not to increase the pressure. Naturally, alcohol and cigarettes with such a disease are completely prohibited.

Garlic

A mild subspecies of pulmonary hypertension can be completely cured with garlic. The fact is that this product expands the vessels of the pulmonary circulation, removes congestion in the veins, thereby reducing pressure. It is also very good for the heart, and it is heart problems that often lead to PH.

The simplest recipe is to eat 2 cloves of garlic every morning on an empty stomach with a glass of water. If you are afraid bad smell out of your mouth, chew the garlic with a mint leaf.

Garlic tea helps a lot. Don't let such an exotic name scare you - such a drink is very tasty and healthy. It will help restore not only the circulatory and respiratory system but the whole organism. Ingredients per serving:

1 clove of garlic;
1 glass of water;
a little ground ginger (about 7-8 grams);
1 tablespoon lemon juice;
1 tablespoon honey.

Put water on fire. When it begins to boil, add the pre-minced garlic clove, ginger and a spoonful of honey. Mix everything well and leave to cook on low heat for about 20 minutes. Then strain the resulting infusion. At the end, add some lemon juice. We recommend drinking this tea on an empty stomach twice a day.

Clover

Clover is very good for the cardiovascular system and will help with your disease. It can be used in many different ways.

If possible, plant clover in a pot at home, and eat the young sprouts of this plant. A tablespoon of herbs will suffice.

You can also make tea from dried clover flowers. For a glass of water, you need a teaspoon of the crushed plant. Pour boiling water over clover, leave for 15 minutes, then drink. Take 2-3 glasses of this drug per day.

Digitalis

Digitalis will save you from pain in the chest and severe shortness of breath, but you need to drink it carefully, increasing the dosage and monitoring the state of the body.

Prepare an alcohol tincture at the rate of 1 part of dry foxglove herb to 10 parts of alcohol with a strength of 70 degrees. Infuse the mixture for 2 weeks, then strain. Start with a dosage of 3 drops twice a day. The tincture should be dissolved in a small amount of water and drunk on an empty stomach. After about a week, the dosage can be increased to 5 drops, then after another week - up to 7 drops. Then move on to 10 drops of the tincture twice a day. The course of treatment lasts from 2 to 4 months.

Hawthorn

Hawthorn dilates blood vessels, helping to reduce systolic and diastolic pressure in the pulmonary artery. It can be used in several ways.

The first way is tea. To prepare a drink, pour a dessert spoon of dried hawthorn flowers and leaves into a mug and pour a glass of boiling water. Keep the glass covered for 15 minutes, then strain the drink. It should be drunk 1 glass in the morning and evening.

The second method is healing wine. You will need 50 g of ripe hawthorn fruit and 500 ml of natural red sweet wine. Crush the berries in a mortar, heat the wine to a temperature of about 80 C. In glass jar or a bottle, pour warm wine, add hawthorn, close the lid and leave for 2 weeks, then strain. Drink 25 ml of this wine every night before bed.

Method three - alcohol tincture. Combine hawthorn flowers with alcohol in a ratio of 1 to 10 and infuse in a glass container for 10 days, then strain. Drink about half a teaspoon of this tincture in the morning and evening on an empty stomach.

mistletoe

It will be much easier for the patient if he starts taking mistletoe. In the evening, pour a teaspoon of grass with a glass of cold water, let the mixture infuse overnight. Warm it up a little in the morning and drink it. This is how you should do it every day.

You can also make wine from mistletoe. You will need 50 g of the plant and 500 ml of dry white wine. Combine these ingredients and infuse for 1 week, then strain. Take 25 ml twice daily before meals.

rowan fruits

The fruits of mountain ash have a beneficial effect on the cardiovascular system. Therefore, replace ordinary tea with tea from this plant. Mash a tablespoon of fruits in a mug, add a small amount of sugar and 200 ml of boiling water. Stir and drink. It is recommended to take 3 servings of this tea per day.

Witch Doctor Collection

There is a good collection of plants recommended by experienced healers. Combine in equal parts adonis herb, valerian root, mint leaves, St. John's wort and dill seeds. At night in a thermos, brew a tablespoon of this mixture with a liter of boiling water and insist until morning. This will be your serving for the whole day, you need to drink the infusion in between meals. Continue the course of treatment for 2 months, then you need to take a break for at least 2 weeks.

Treatment with juices and smoothies

Juice is a natural healer that will help to cope with many problems, including PH. We will give some of the most effective recipes.

Juice for the heart

With pulmonary hypertension, you need to support the work of the heart. To do this, prepare this mix:

2 glasses of red grapes;
1 grapefruit;
1 teaspoon crushed linden flowers;
¼ teaspoon powdered cloves

Combine all these ingredients and mix in a blender. You need to drink smoothies immediately after preparation, it is recommended to take a glass a day. Within weeks, you will notice positive changes.

Juice to normalize pressure

Connect the following components:

juice of 1 grapefruit;
juice from 2 oranges;
6 sprigs of fresh parsley;
2 tablespoons of hawthorn flowers;
3 kiwis, peeled and chopped

Mix everything in a blender and drink immediately after preparation. Take this remedy in the morning and in the evening so that the arterial and pulmonary pressure is always normal.

Juice for shortness of breath

If shortness of breath is tortured, conduct a monthly course of treatment with this juice:

5-6 fresh dandelion leaves;
1 tablespoon of red clover flowers;
1 red apple;
1 cup shredded Brussels sprouts;
1 large carrot;
0.5 cup chopped parsley

Squeeze juice from apple, carrot and Brussels sprouts, mix juices, add parsley, red clover and finely chopped dandelion leaves. Take juice on an empty stomach, 1 glass twice a day.

Juice for general well-being

You will need:

half a melon;
1 glass of fresh strawberries;
a piece of ginger root 2.5 cm long;
1 orange;
1 grapefruit;
¼ cup natural yogurt (no additives)
half a handful of wheat germ.

Squeeze juice from orange, melon, strawberry and grapefruit. Grate the ginger. Combine juices, add ginger, yogurt and wheat germ. Drink to your health!

Pulmonary hypertension (PH) is pathological condition which is characterized by poor health and high blood pressure. The disease without timely intervention gradually progresses and leads to serious disruption and damage to the right ventricle of the heart muscle.

Pathology is characterized by severe symptoms that can lead to death. It is important to detect the disease in time and begin to prevent negative consequences.

What is pulmonary hypertension?

Pulmonary hypertension is a narrowing of the vessels of the lungs, which leads to an overload of the right ventricle of the heart and is manifested by high blood pressure. Most often, the disease is a secondary syndrome due to other disorders in the cardiovascular system. But PH can also be an idiopathic pathology.

ATTENTION! The main hallmark of hypertension is pulmonary arterial pressure above 25 mmHg. Its constant deviation from the norm and the development of pathology leads to disruption and cessation of myocardial functionality, which in a short time can lead to death.

Developing PH is able to influence the state of the entire cardiovascular system, affecting its precapillary (arterioles) and postcapillary (venules) departments, which are responsible for resistance to blood flow in the vessels of internal organs.

The most common primary and secondary types of pulmonary hypertension occur in young women aged 20 to 40 years. The causes of their occurrence and the further development of the disease differ in etiology.

Primary

Pulmonary idiopathic arterial hypertension (Aerz's disease) is a rare disease, in most cases - inherited. A characteristic manifestation of primary PH is a change in the size of the right ventricle and pathological lesions of the pulmonary artery.

The disease progresses rapidly, which puts people who suffer from it at risk of early death. It is possible to prevent it with the timely detection of hypertension, which is characterized by vivid symptoms, as well as with its mandatory treatment.

Secondary

Secondary PH is not a separate type of disease, but a complication of existing diseases, due to which it occurs. Among them:

autoimmune diseases, in particular HIV;
connective tissue diseases;
the presence of VPS ();
diseases and pathologies of the respiratory system;
left ventricular failure.

The manifestation of external and internal signs hypertension in its secondary form does not differ from idiopathic PH, with the exception of concomitant symptoms of diseases that provoked the development of pathology.

REFERENCE! This type of disease is more common than its primary form, it is curable with timely diagnosis and the cause of the complication.

Classification of the disease according to the nature of the course

Pulmonary hypertension, depending on the complexity and nature of the course of the disease, is classified according to degrees according to the ICD:

1st degree, characterized by the absence of severe symptoms, especially in people suffering. Pathology begins to develop gradually, blood pressure will be slightly increased, while the muscle activity and well-being of the patient remain unchanged.
2nd degree, in which blood pressure increases, the first external signs pathologies that manifest themselves after physical activity in the form of shortness of breath, fatigue, impaired coordination. It is also possible to lose strength with a deterioration in the patient's well-being.
The 3rd degree is distinguished by increased even at rest and with little physical activity. The patient's blood pressure will be significantly elevated even in the presence of hypertension.
The 4th degree, which is the last, is characterized by pronounced symptoms with painful sensations and constant weakness. Blood pressure at this stage of the development of the pathology will be significantly higher than the normal limits, the patient's physical activity will become as difficult as possible.

ATTENTION! It is important not to start the disease to the extreme stage, which in many cases ends in death. The patient needs to monitor blood pressure and well-being.

Causes of the disease

Alexander Bakulev, one of the founders of cardiovascular surgery, and Leo Bokeria, a well-known Soviet cardiac surgeon, studied the characteristics of cardiovascular disease, as well as the definition of the main causes of PH and the treatment measures that depend on them.

The main reasons for the development of PH include chronic diseases and pathological changes in the heart muscle and respiratory system:

obstructive bronchitis;
bronchial asthma and chronic tuberculosis;
bronchiectasis (formation of cavities and suppuration in the lungs);
fibrosis of lung tissue caused by pathological changes in the body;
congenital heart defects, in particular, defects and septa, ventricular and valve defects;
diseases that provoke disruptions in the functioning of the circulatory system and lead to stagnation of blood (, coronary artery disease,);
alveolar hypoxia, which is the most common cause of PH;
defects in the structure of lung tissues;
attacks of hypertension,;
deviations of the blood structure from the norm due to an increased concentration of red blood cells;
HIV infection;
cirrhosis of the liver in an advanced stage;
acquired;
, characterized high blood pressure in the portal vein due to lesions of the liver;
hyperthyroidism, in which there is an excessive secretion of thyroid hormones;
neoplasms in the chest, its deformation;
compression of the pulmonary vessels due to obesity;
intracranial hypertension arising from pathologies of the brain with concomitant;
left ventricular failure;
metabolic disorders and metabolic processes in organism.

External factors can also provoke the occurrence of pulmonary hypertension, including:

prolonged use of narcotic drugs, antidepressants and anorexigens;
the impact of toxins and biological poisons when living in places with poor ecology;
especially in women with hypertension;
accommodation and frequent stay in the highlands.

Often, PH occurs as a result of several causes at once in the form of diseases of the cardiovascular and respiratory systems.

Symptoms of the development of PH

At the 1st stage of development, pulmonary hypertension often does not manifest itself, with the exception of a slight increase in blood pressure.

The progression of the disease occurs gradually, its symptoms begin to appear already at the 2nd stage. Clinical picture PH includes the manifestation of such signs:

Shortness of breath, difficulty breathing at rest, aggravated by physical activity.
Increased heart rate (attacks of tachycardia), resulting from respiratory failure and hypoxia.
Painful sensations of a squeezing nature in the chest.
Fainting states.
Increased fatigue and constant weakness.
Vertigo.
Attacks of suffocation at night.
Swelling of the extremities.
Blueness of the skin.
Pain in the liver, resulting from its pathological increase in volume.
Soreness and heaviness in the right hypochondrium.
Gastrointestinal disorders in the form of nausea, vomiting, bloating and flatulence.
Sudden and rapid weight loss.
Attacks of dry cough with hoarseness.
Coughing fits with expectoration and blood.
Swelling and bulging of the veins in the neck.

IMPORTANT! The manifestation of symptoms occurs with an increase in blood pressure by 2 times or more. , in particular in babies, the symptoms appear more severely and at an accelerated pace, which is why it is important to monitor their health.

Diagnostic measures

To determine pulmonary hypertension, you need to undergo a complete examination in a medical institution. Passage of diagnostics includes the following research methods:

Catheterization of the pulmonary artery, necessary to clarify the blood pressure in it.
Delivery of blood tests (general and biochemical) to determine its composition and comparison with a special code, deviations from which indicate the presence of a malfunction in the body.
Angiopulmonography, during which it is possible to assess the condition of the vessels of the lungs.
CT, the results of which can determine the size of the pulmonary artery and the presence of concomitant diseases and pathologies of the heart muscle and lungs.
A test for determining endurance and exercise tolerance, contributing to the diagnosis and clarification of the stage of development of PH.

Also, to exclude diseases with similar symptoms, it can be carried out differential diagnosis using:

coagulograms to determine blood clotting (excluding thrombosis);
Ultrasound of organs abdominal cavity(exclusion of diseases of the gastrointestinal tract);
liver function tests (exclusion of cirrhosis and hepatitis);
HIV test.

Only a full examination allows you to establish the exact disease and determine its stage for the appointment of further treatment.

Methods of treatment

Pulmonary hypertension is treated by a therapist and a cardiologist. Its methods depend on the stage of progression of the pathology, the general condition of the patient and his individual characteristics.

Regardless of the cause of the disease and the degree of its development, the treatment algorithm is as follows:

Identification and elimination of the root cause of the disease.
Decreased blood pressure in the lungs.
Prevention of thrombosis in the arteries.
Symptomatic treatment of the patient.

Comprehensive therapy based on these principles includes:

the use of a course of drugs in the form of tablets and injections;
basic treatment of a patient suffering from PH;
application of funds traditional medicine;
surgical intervention in severe stages of pathology.

REFERENCE! Symptomatic therapy may be included in the treatment to eliminate the causes that provoke the development of PH and other pathologies, as well as radiation therapy when a tumor is detected in the lung region that has arisen against a background of hypertension.

Medical therapy

The use of drugs is necessary to eliminate the cause of the pathology and alleviate the patient's condition. Mandatory medications include:

Calcium antagonists - to reduce spasm of the vessels of the pulmonary circulation, reduce platelet adhesion and eliminate hypoxia ("Nifedipine", "Verapamil").
Diuretics and diuretic drugs - for excretion excess fluid from the body and lowering blood pressure ("Lasix", "Veroshpiron").
ACE inhibitors and - to reduce pressure, dilate blood vessels and reduce the load on the heart muscle ("Quadropril", "Lizinopril").
Nitrates - to reduce the load on the heart ("Kardix", "Nitromint").
Antiplatelet agents - to normalize the content and activity of erythrocytes and platelets in the blood ("Clopidogrel", "Iloprost").
Anticoagulants - to prevent thrombosis ("Aspinat", "Dethromb").
Endothelin receptor antagonists - for vasodilatation ("Bosentan", "Sitaxentan").
Vasodilators - to relax the smooth muscle layer of blood vessels ("Nifedipine", "Prazosin").
Bronchodilators - to restore and improve ventilation of the lungs ("Fenoterol", "Berodual").
Antibiotics - to cure bronchopulmonary infections, if any (Azitrox, Fromilid).
Prostaglandins - for enhanced vasodilation and ("Vazaprostan", "Edex").

It is also acceptable to use symptomatic drugs to alleviate the general condition of the patient. Their reception should be prescribed by a doctor in the required amount, depending on the severity of the symptoms.

Basic treatment on an ongoing basis for PH

In addition to taking medication, it is important to adhere to the basic treatment in the presence of pulmonary hypertension. It is based on following recommendations and requirements:

reducing the amount of fluid consumed to 1.5 liters per day;
reducing the amount of salt consumed;
carrying out oxygen inhalations;
compliance with the dosing of physical activity;
the exclusion of heavy physical exertion, in particular, lifting to a height;
control of mental and emotional state;
giving up bad habits, strong caffeine-containing, as well as tonic and.

IMPORTANT! Exceptionally basic treatment is not able to affect getting rid of PH, but in combination with medical and surgical (if necessary) therapy, it has a positive effect on the patient's health.

Surgical intervention

Severe degrees of development of pulmonary hypertension require surgery. Surgical intervention, depending on the neglect of the pathology, can take place in one of the following forms:

Creation of an artificial opening between the atria of the heart muscle to reduce pressure in the right ventricle.
Lung elimination.
Heart and/or lung transplantation in severe cases of pathology in the presence of irreversible changes and chronic diseases.

Operations in most cases are successful, but require long-term rehabilitation of patients.

ethnoscience

Traditional medicine contributes to the treatment of pulmonary hypertension, strengthens and enhances the effect of mandatory drug therapy. Effective recipes include:

Rowan decoction. Need 1 tbsp. l. berries pour 100 ml of water, boil and let cool. Take the drug should be 0.5 cup three times a day. The decoction helps to normalize blood pressure and strengthen blood vessels.
A decoction of viburnum. It is necessary to pour 20 g of berries into 200 ml of hot water and boil, let the product brew for an hour. It is recommended to use the product 50 ml once a day. It lowers blood pressure and boosts immunity. More effective viburnum recipes are collected in our article:
Garlic. It is necessary to eat 3 cloves 1 time daily to maintain normal pressure and cleanse the venous tract.
Decoction of Adonis. It should be 1 tsp. dried herbs pour 200 ml of boiling water, let it brew for 2 hours. You need to take the remedy for 2 tbsp. l. a day before meals, which will favorably affect the restoration of blood pressure;
Decoction of birch buds. It should be 1 tsp. swollen crushed dry kidneys pour 200 ml of water and boil half in a water bath. Strain the broth and take 1 glass during the day to normalize the pressure.
Melissa infusion. You need 1 tsp. dry leaves pour 250 ml of boiling water and let it brew for 30 minutes. The tool should be squeezed out and taken 1 tbsp. l. three times per day. The infusion can lower blood pressure.

ATTENTION! Traditional medicine is allowed to be taken only after discussion with the doctor!

Possible consequences and complications of the disease

Pulmonary hypertension in the course of its development can lead to negative consequences and complications in the form of chronic diseases and pathologies. These include:

right ventricular failure;
thrombosis of pulmonary arteries, thromboembolism;
hypertensive crises;
pulmonary edema.

Such severe complications without timely therapeutic intervention, they can lead to further death.

Forecast and prevention

The prognosis of PH disease with timely treatment is most often favorable. In the absence of timely diagnosis and therapy, the prognosis worsens significantly. It is also influenced by the cause of the development of pathology. So, in the absence of concomitant severe and chronic symptoms the chance of recovery increases significantly, and in the presence of severe diseases of the cardiovascular system, on the contrary, the risk of death increases.

To avoid the development of pulmonary hypertension, it is recommended to follow simple preventive rules:

lead a healthy and active lifestyle;
give up bad habits in the form of smoking and alcohol abuse;
do not delay the treatment of infectious diseases;
observe the measure during physical activity;
avoid stressful situations, emotional outbursts.

Conclusion

Pulmonary hypertension can be fatal. Severe symptoms of the disease require immediate treatment to the clinic for diagnosis and therapy. It is important to monitor the state of health, maintain healthy lifestyle life and visit doctors regularly to prevent the development of hypertension, its progression and the occurrence of complications.