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Pulmonary hypertension is high blood pressure in the blood vessels that supply the lungs (pulmonary arteries).
It's a serious condition that can damage the right side of the heart.
The walls of the pulmonary arteries become thick and stiff, and can't expand as well to allow blood through.
The reduced blood flow makes it harder for the right-hand side of the heart to pump blood through the arteries.
If the right-hand side of your heart has to continually work harder, it can gradually become weaker. This can lead to heart failure.
Pulmonary hypertension is a rare condition that can affect people of all ages, but it's more common in people who have another heart or lung condition.
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Symptoms of pulmonary hypertension include:
The symptoms often get worse during exercise, which can limit your ability to take part in physical activities.
If you have a type of pulmonary hypertension known as pulmonary arterial hypertension (PAH), you may not have any symptoms until the condition is quite advanced.
See your GP if you have any symptoms of pulmonary hypertension. They'll ask you about your symptoms and medical history, and they may carry out a physical examination.
Correctly diagnosing pulmonary hypertension can sometimes take time because its symptoms are similar to those of many other heart and lung conditions.
Tests you may have include a type of heart scan called an echocardiogram, and right heart catheterisation, where a thin, flexible tube is inserted into your pulmonary artery.
Read more about how pulmonary hypertension is diagnosed.
The changes in the pulmonary arteries that lead to pulmonary hypertension can be caused by:
Read more about the causes of pulmonary hypertension.
Pulmonary hypertension can't be cured, but treatment can reduce the symptoms and help you manage your condition.
Pulmonary hypertension usually gets worse over time. Left untreated, it may cause heart failure, which can be fatal, so it's important treatment is started as soon as possible.
If another condition is causing pulmonary hypertension, the underlying condition should be treated first. This can sometimes prevent the pulmonary arteries being permanently damaged.
Treatments for pulmonary hypertension may include anticoagulant medicines to reduce the blood's ability to thicken (clot) and diuretics to remove excess fluid as a result of heart failure.
You may also be offered medication to widen the blood vessels.
Home oxygen treatment may also be prescribed if the level of oxygen in your blood is low.
Read more about treating pulmonary hypertension.
The outlook for pulmonary hypertension varies, depending on factors such as:
The specialist in charge of your care will be able to give you more detailed information.
Having pulmonary hypertension can affect your ability to carry out everyday activities.
The charity Pulmonary Hypertension Association UK offers practical information and support for people living with pulmonary hypertension and their friends and families.
Pulmonary hypertension is caused by changes to the pulmonary arteries, the blood vessels that carry blood from the heart to the lungs.
There are five main types of pulmonary hypertension, depending on the underlying cause. These are described below.
Pulmonary arterial hypertension (PAH) is caused by changes in the smaller branches of the pulmonary arteries.
The walls of the arteries become thick and stiff, narrowing the space for blood to pass through and increasing blood pressure.
PAH can be associated with other conditions, including:
A small number of people develop PAH without having any other medical condition. This is called idiopathic PAH. In very rare cases, PAH can be inherited.
In rare cases, newborn babies can have high pressure inside their blood vessels, which means their heart can't pump enough oxygenated blood around their body. This is known as persistent pulmonary hypertension of the newborn (PPHN).
Treatment in an intensive care unit may be needed if simple measures such as keeping the baby warm and giving oxygen don't increase oxygen levels to normal.
The Great Ormond Street Hospital for Children website has more information about persistent pulmonary hypertension of the newborn.
If there are problems with the left side of the heart, the right side has to work harder to pump blood through the lungs. This increases blood pressure in the pulmonary arteries.
Problems with the left side of the heart are thought to be the most common cause of pulmonary hypertension. These include mitral valve problems, left ventricle problems and aortic valve conditions.
Pulmonary hypertension is also sometimes linked with lung diseases or lack of oxygen (hypoxia), including:
Low levels of oxygen in the blood make the pulmonary arteries narrow. This squeezes the blood into a smaller space, which increases blood pressure, causing pulmonary hypertension.
Pulmonary hypertension can sometimes be caused by scars from previous blood clots that narrow or block the pulmonary arteries. This is called chronic thromboembolic pulmonary hypertension.
A blood clot that blocks one of the blood vessels that supply your lungs is called a pulmonary embolism.
Other, less common, causes of pulmonary hypertension include:
Read about how pulmonary hypertension is diagnosed.
Pulmonary hypertension can be difficult to diagnose because the symptoms are similar to those of other heart or lungs conditions.
This means there can sometimes be a delay before a correct diagnosis is made.
See your GP if you have symptoms of pulmonary hypertension, such as breathlessness and tiredness.
Your GP will ask about:
You may also have a physical examination where your GP will listen to your heart and lungs, and check for any swelling in your legs or ankles.
If your GP thinks you may have pulmonary hypertension, they'll recommend further tests.
The two main tests used to help diagnose the condition are:
Other tests you may have include:
If you're diagnosed with pulmonary hypertension, your condition will be classified depending on how severe your symptoms are. This is to help work out the best treatment for you.
It's usually classified into four types, where:
Read about how pulmonary hypertension is treated.
Pulmonary hypertension can't be cured, but treatments can reduce your symptoms and help you manage your condition.
If the cause is identified and treated early, it may be possible to prevent permanent damage to your pulmonary arteries, the blood vessels that supply your lungs.
If pulmonary hypertension is caused by another condition, such as a heart or lung problem, treatments will focus on the underlying condition.
You may also be offered an operation known as a pulmonary endarterectomy.
If you have pulmonary arterial hypertension (PAH), you'll be referred to a centre that specialises in treating this form of the condition. There are seven centres in England and one in Scotland.
There are many treatments for pulmonary arterial hypertension (PAH). Which treatment or combination of treatments you'll be offered will depend on a number of factors, including what's causing PAH and the severity of your symptoms.
There are also a number of specialist treatments for PAH that help relax the arteries in the lungs and reduce the blood pressure in the lungs.
These medicines slow the progression of PAH, and may even reverse some of the damage to the heart and lungs.
You can find detailed information about these treatments for pulmonary hypertension on the Pulmonary Hypertension Association UK website.
Some people with pulmonary hypertension may need surgery. The three types of surgery currently used are:
The National Institute for Health and Care Excellence (NICE) also has guidance on balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension.