High Blood Pressure in Your Lungs Could Mean High Risk

High blood pressure usually affects vessels in your body. But a less common type of high blood pressure, called pulmonary arterial hypertension (PAH), can affect your heart and is much more fatal.

PAH is considered to be a rare lung disorder because it occurs in only about two people per million each year — but in twice as many women than men. While some patients have a genetic predisposition to the disease, others develop PAH for no known reason. Using certain appetite suppressants or abusing drugs such as cocaine can trigger the disease, but most patients with PAH have other health problems already, such as leaking or blocked heart valves, heart failure or lung disease, that affect the heart’s ability to pump blood through the pulmonary arteries. In addition, some non-cardiac conditions, including liver disease, HIV infection and scleroderma, can lead to PAH.

“The pulmonary arteries carry blood from the heart to the lungs,” says David D’Alessandro, MD, a cardiothoracic surgeon at the Montefiore-Einstein Heart Center and associate professor of Cardiothoracic Surgery at the Albert Einstein College of Medicine. “Normally, the right ventricle of the heart doesn’t need to work hard to pump blood through the pulmonary arteries. But in some patients, the blood pressure in these vessels is consistently high. Without treatment, PAH can eventually weaken the muscle on the right side of the heart and lead to heart failure.”

Doctors can’t measure the pressure in the pulmonary arteries with the same cuffs they use to measure blood pressure throughout the body. They may order echocardiograms, pulmonary artery catheterizations or other sophisticated tests to confirm the diagnosis in patients who have conditions or symptoms of disorders that can cause PAH.

Proper diagnosis is just as important as the treatment for PAH, since it varies for each patient depending on the underlying cause of their disease. For example, doctors may repair or replace defective heart valves or recommend medical and surgical treatments for congestive heart failure or lung disease. In less severe cases, they may prescribe medications or recommend lifestyle changes that can help relieve symptoms and improve patients’ quality of life. Dr. D’Alessandro warns that early detection gives patients the best fighting chance.

“At the Montefiore-Einstein Heart Center, we offer comprehensive diagnostic and treatment services for PAH,” he adds. “We’re also working on aggressive treatments and investigating new approaches that may make treatment for PAH safer and more effective. But the key is recognizing the signs early and seeking proper care.”

Look for These Signs of Pulmonary Arterial Hypertension (PAH)
Symptoms of PAH often are caused by the conditions that lead to the disease. Common signs of PAH include:

• Shortness of breath
• Fatigue
• Chest pain, especially during physical activity
• Racing pulse
• Swelling in the ankles or legs
• Dizziness, fainting or passing out
• Blue-tinted lips and skin