Pulmonary hypertension

Pulmonary hypertension is a severe, potentially fatal disease that affects lung and heart. Normal pulmonary artery pressure in systole is 20 to 30 mm Hg and in diastole about 10 mm Hg.

Pulmonary hypertension is defined as a mean pulmonary artery pressure exceeding 25 mm Hg and a mean pulmonary arterial pressure above 18 mm Hg.

It is symptomatically characterized by shortness of breath, fatigue and fainting which is severely exacerbated through exertion due to an increase in blood pressuring the lung vasculature finally leading to a progressive worsening of hemodynamic function, right ventricular hypertrophy, right heart insufficiently and finally right heart failure.

It is a group of conditions with multiple causes rather than a single one. Pathogenesis amnd management doffer among entities.

The path physiological mechanisms that may result in pulmonary hypertension are as follows:
1. Increased pulmonary blood flow
2. Prolonged left atrial hypertension
3. Organic vascular obstruction
4. Pulmonary vasoconstriction

Pulmonary hypertension can be grouped into to one of five general categories based on similar pathophysiologic processes and treatment
1. Pulmonary arterial hypertension (PAH)
2. Pulmonary venous hypertension
3. Pulmonary hypertension associated with lung disease and/or hypoxemia
4. Pulmonary hypertension caused by chronic thrombotic or embolic disease
5. Miscellaneous disorders associated with pulmonary hypertension 

Pulmonary arterial hypertension as a group of pulmonary hypertension is rare, progressive, currently incurable and terminally fatal. With a prevalence of about 15-50 patents per one million inhabitants the disease is classified as an ‘orphan disease’.

The most common systems associated with pulmonary hypertension are dyspnea, tachypnea, and chest pain. Decreased exercise tolerance is a frequent complaint, and syncope and light headedness are reported less often.
Pulmonary hypertension