Pulmonary Hypertension: Symptoms, Risk Factors, and Complications
The condition affecting the arteries of the heart and lungs is known as pulmonary hypertension. It is among the harmful types of high blood pressure diseases. It causes arterial distension, thickening, and blockage, leading to an increase in the heart’s pumping force.
Increased pressure exertion by the heart causes the weakening of cardiac muscles and can also lead to heart failure. PVRI is the parameter used to predict the outcomes in case of a transplant when the heart fails to function due to pulmonary hypertension.
Symptoms of Pulmonary Hypertension
Pulmonary hypertension can stay idiopathic for some time, and the individual may not notice any symptoms. As the disease progresses gradually, the individual may experience these.
It is also known as “air hunger” because the patient’s lungs scramble for breath. People with Dyspnea feel pressure in their chest and suffer from labored breathing. Initially, it only happens when exercising or climbing stairs. But with the progression of the disease, the individual may feel out of breath even when resting.
The patients feel physically tired, even when they are not working strenuously. Their muscles and bones feel weary, and they have little energy to do anything. Other signs of fatigue include slow reflexes, concentration problems, and a drastic lack of motivation.
In extreme cases of exhaustion or fatigue, the patient may feel dizzy and pass out. It results from a sudden decline in pulse and blood pressure. When the brain does not receive sufficient blood, it cannot function properly. Eventually, the person loses conscience.
- Chest pain
As per reports, patients with pulmonary hypertension feel a coercive feeling in their chest occasionally. When severe, it could be a burning, strangling, or stabbing sensation that requires urgent attention. However, chest pain can also happen due to other causes like indigestion and swelling of ribs. So, it is crucial to report the accompanying symptoms to the doctor.
It refers to the swelling and inflammation of body parts and occurs due to the poor regulation of tissue fluids in the body. Patients with pulmonary hypertension may observe a numb sensation in their lungs. This inflammation restricts the passage of air, causing discomfort and ache while breathing. Edema in the ankles and legs and ascites of the abdomen can also occur.
Heart complications, like pulmonary hypertension, can trigger asthma attacks. These result in deoxygenation of blood, which causes the skin to discolor- developing a condition called cyanosis. The affected patients find that their lips and skin turn bluish. It can also impact the tongue and fingernails.
- Heart Palpations
Heart palpitations and a racing pulse are also a common symptom. People with blood pressure problems feel that their heart is audibly pounding in their chest. Their heartbeat falls out of rhythm, and they may experience fear and anxiety.
Risk Factors for Pulmonary Hypertension
The senior population is at a higher risk of developing symptomatic pulmonary hypertension, whereas younger adults are at more significant chances of developing idiopathic pulmonary hypertension. Other things that are potential risk factors include:
- Family history
Though an individual’s habits have a considerable say in their diseases, their family history also plays a role. Doctors have found a correlation between hypertension and genetics, so the phrase “it runs in the family” is not scientifically invalid.
Hence, genetic disorders, such as congenital heart disease, can worsen the threat of pulmonary hypertension.
People with obesity require more oxygen and nutrients to stay healthy, as their bodies get accustomed to their eating habits. Their heart also has to exert more pressure, so slight issues can provoke significant complications. Unfortunately, compared to a healthy individual, people with obesity have a 24% greater risk of stroke and are 12% more likely to acquire coronary heart disease. Thus, they are also susceptible to pulmonary hypertension.
- Blood Clotting Disorders
Blood coagulation restricts the blood vessels, so the heart has to work harder to pump the same amount of blood. This situation raises the heartbeat and blood pressure. A family history of blood clotting in the lung arteries also puts the individual at higher risks of developing pulmonary hypertension.
- Asbestos Exposure
Asbestos refers to a hazardous mineral commonly found in coal mines. People who work in brick factories and kilns are also at risk of contracting it. Prolonged asbestos exposure can deteriorate the heart, alongside the lungs. It can also debilitate the circulatory system and cause pulmonary hypertension.
Asbestos exposure can be very challenging to identify because most people show symptoms almost 20 years after they first contact it as it remains latent till then.
- Residency at High Altitudes
Naturally, the air pressure reduces as we move higher up the sea level. So, living in mountains or other high altitude regions can give the individuals a higher respiratory rate. The cardiac muscles also have to exert more force to maintain the blood flow.
According to a survey, 15% of the people who were healthy at home counteracted heart diseases when they adopted the new lifestyle at a higher altitude. People may also face nausea, insomnia, and dizziness, alongside pulmonary hypertension.
- Drug Consumption
Due to the government campaigns and increased awareness, many people are familiar with the lung complications caused by drugs. However, a lesser-known fact is that drug consumption can have adverse cardio-vascular impacts. It is because drugs release chemicals and hormones like dopamine that unnaturally change the balance of the body.
Some drugs are more likely to impact the heart than others. Unfortunately, the harmful category comprises Selective Serotonin Reuptake Inhibitors (SSRIs), which are used for treating depression and anxiety. Other illegal drugs, such as cocaine, can also tarnish the heart.
Complications of Pulmonary Hypertension
Pulmonary hypertension comes with various other complications as well. Some of them are discussed below.
- Cor Pulmonale
A potential complication caused due to pulmonary hypertension is cor pulmonale. It happens when the heart’s right ventricle enlarges and exerts more force to pump the blood. This ventricle enlargement is due to the blockage, distension, or narrowing of the heart or lungs’ arteries due to pulmonary hypertension. Because it is common in the right side of the heart, people also refer to it as “right-sided heart failure.” It is a critical condition, as the rate of people who survive with Cor Pulmonale for five years is only 50%.
- Blood Clotting
Pulmonary hypertension also triggers clot development in the small arteries of the lungs. It can be life-threatening because the anatomy of arteries is already affected by pulmonary hypertension.
Leaving the blood clots untreated can also cause the patient to develop Chronic Thromboembolic Pulmonary Hypertension (CTEPH). This condition generates more blood clots that can block the narrowed arteries, leading to stroke or heart failure.
Another consequence of pulmonary hypertension is Arrhythmia. It comprises Tachycardia, in which the heart beats shockingly fast, and Bradycardia, when the heartbeat is incredibly slow. Such irregular breathing patterns in an individual can also lead to palpitations, dizziness, or fainting spells. Some forms of Arrhythmia also prove to be fatal.
- Hemoptysis and Pulmonary Hemorrhage
Pulmonary diseases often result in the patient’s lungs suffering from problems like asthma, inflammation, and tissue fluid. It is because hearts and lungs work harmoniously to filter and circulate oxygenated blood, so complications in one organ affect the other.
The over distension, or painful inflation of the arteries, can trigger internal bleeding of the lungs. It is medically known as pulmonary hemorrhage and is a life-threatening condition. Bleeding in the lungs also leads to hemoptysis, in which the individual coughs up blood. It happens when some blood diffuses into the mucus in the lower respiratory tract.
- Pregnancy Problems
Most doctors regard pulmonary hypertension as a contraindication for pregnancy by advising the patients not to bear children. There are several reasons behind it.
Pregnancy causes many physiological changes to the human body, and women with pulmonary hypertension are not well-equipped with handling these changes. Due to the baby’s development, their heart has to increase the cardiac output (the blood flow per minute). This increased exertion causes a pressure build-up in their chest, making them susceptible to strokes.
The subsequent delivery and labor also include increased demand for blood flow due to uterus contractions. It can cause the assimilation of Carbon dioxide into the bloodstream, leakage of tissue fluid, and arteries’ constriction. All of these drastically increase the risk of heart failure during labor.
- Cardiac Cirrhosis
Some patients with pulmonary hypertension also develop liver complications. These occur because the disease elevates the pressure in the right ventricle. This imbalance triggers chronic liver injury, which comprises swelling and inflammation of the liver due to inadequate blood and oxygen.
Once this happens, the liver tries to rebuild healthy tissue. The attempt often backfires and the scarry tissue accumulates on liver walls, causing the patient to suffer from cirrhosis or fibrosis.
Despite being a rare condition, pulmonary hypertension exhibits many symptoms in patients. People who have are obese, a medical history of heart disorders, consume drugs, or live at higher altitudes, are more likely to develop this disease. If left untreated, it can create severe complications, such as liver injury, blood clotting, and heart failure. Thus, people with symptoms must consult a cardiologist as soon as possible.