Community Health Network

pulmonary hypertension
Asked on Tuesday, September 27, 2011 by Christina

What is the difference between pulmonary hypertension and regular hypertension?

From Sandeep Dube M.D. (Ask a Question)

Dear Christina,

Thank you for an interesting question. Pulmonary Arterial Hypertension (PAH) is different from ordinary hypertension, which is high blood pressure throughout the body. In PAH, the high blood pressure is in the arteries between the heart and lungs. In patients with PAH, the pulmonary arteries that go from the heart to the lungs become tight, thick and stiff. This creates more resistance to blood flow.

In a person with PAH, the vessels in the lungs become narrowed, making it much more difficult for the blood to flow through them. The affected lungs make the heart work harder, making it harder to

pump against these high pressures. Over time, this strain can cause the walls of the heart to thicken and the right side of the heart to become enlarged and less blood is able to flow through the lungs, resulting in less oxygen throughout the body.

Cardiomyopathy refers to diseases of the heart muscle. The heart muscle becomes enlarged, thick or rigid. The heart muscle becomes weak and is less able to pump blood through the body. An echocardiogram is frequently ordered to help diagnosis cardiomyopathy. It is a simple non-invasive test.

Pulmonary hypertension may be caused by many different sources many times the reason is unknown. Autoimmune disease, blood clots, congestive heart failure, heart valve disease, HIV infection, low oxygen level in the blood for long periods of time, COPD, or pulmonary fibrosis, obstructive sleep apnea or sometimes medications can cause pulmonary hypertension. Symptoms are the same for both PAH and cardiomyopathy; they include ankle and leg swelling, bluish color of the lips or skin, chest pain or pressure most commonly in the front of the chest, dizziness or fainting spells and fatigue, and weakness. Patients with the diagnosis of PAH usually report symptoms come and go, having good days and bad days.

There is no known cure for PAH. The goal of treatment is to control symptoms and prevent more lung damage. It is important to treat medical disorders that cause pulmonary hypertensions, such as obstructive sleep apnea, lung conditions and heart valve disorders.

It is very important to get early and appropriate treatment and to get an accurate diagnosis to determine between PAH, cardiomyopathy or other disease processes. In the early stages of PAH, test results may be normal or almost normal. Therefore, PAH may take several months to diagnosis. Asthma and other diseases may cause similar symptoms and must be ruled out.