Pulmonary hypertension is characterized by an increase in the blood pressure in the lung. It is defined by a mean pulmonary artery pressure (PAP)≥ 25 at rest with normal PCWP. Pulmonary hypertension affects men and women of all ages. It is a serious condition that can progress without detection because clinical clues are nonspecific. Once suspected, pulmonary hypertension should be evaluated aggressively.
- Shortness of breath on exertion.
- Unexplained chest pain that may worsen on exertion.
- Syncope (fainting) or near-syncope.
Suggestive Physical Signs:
- Increased second heart sound.
- Left parasternal lift or heave.
- Tricuspid murmur.
- Signs of Right Heart Failure - venous distension, ankle swelling (abdominal distension).
Other Suggestive Findings:
- Chest X-Ray - enlarged pulmonary arteries.
- EKG criteria for right ventricle hypertrophy.
- Echocardiogram - enlarged RV, septal flattening, increased pulmonary artery pressures, tricuspid regurgitation.
Risk Factors for Pulmonary Hypertension
- Family history.
- Collagen vascular diseases.
- Cirrhosis of liver.
- Blood clots in legs or lungs.
- Drugs (diet pills, cocaine, amphetamines).
- Sleep apnea.
- Sickle cell disease.
- Congenital heart disease.
- COPD, pulmonary fibrosis.