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Pulmonary hypertension: causes, symptoms, treatment and extent of the disease

Pulmonary hypertension, what is it?

With increasing pressure in the pulmonary artery and its associated vessels - doctors talk about the development of pulmonary hypertension. Usually, the disease is caused by another disorder. But if it is not possible to establish the cause of the disease, then pulmonary hypertension is considered as the primary pathology.

Clinical statistics show that this disease develops very rarely, but this does not diminish its danger: few patients manage to survive, especially with an unclear etiology of the disorder.

Pulmonary hypertension is characterized by a decrease in the lumen of the pulmonary vessels due to excessive proliferation of the endothelium. As a result, the blood flow and gas exchange process is disturbed, from which the entire body suffers.

The heart seeks to compensate for this deficiency at its own expense, by increasing the number of contractions, which inevitably leads to thickening of the myocardium of the right ventricle. Normally, each person's left side of the "motor" is massive, because it starts a large circle of blood circulation.

One of the consequences of pulmonary hypertension is the pulmonary heart.

According to the cardiogram, the doctor may suggest a disease, but in the early stages of the pathology even this diagnostic method does not show significant abnormalities.

Content

Causes of Pulmonary Hypertension

What is pulmonary hypertension

What is pulmonary hypertension

Doctors find it difficult to name the specific cause of pulmonary hypertension. Disorders in the growth of the endothelium are associated with changes in the balance of substances entering the body, such as potassium and sodium.

These chemical elements are directly involved in the process of contraction and expansion of blood vessels, and the body reacts to their deficiency with such a spasm.

But not every person develops pulmonary arterial hypertension due to the lack of necessary components, so doctors attach great importance to heredity.

Often, pathology occurs against a background of another disorder, such as chronic obstructive pulmonary disease or congenital heart disease. In such cases, pulmonary hypertension is considered a complication, although it does not exempt from treatment.

The positive point is the clarity of the problem, which makes it possible to choose the right therapeutic course.

The fact of the influence of the amino acid tryptophan on endothelial growth is considered to be proven. In the 80s of the 20th century, rapeseed oil was widely used in Spain, however, due to its use, the number of diseases of pulmonary hypertension increased significantly.

Laboratory analysis demonstrated the presence of a high concentration of tryptophan in rapeseed, which turned out to be the cause of the disease. In addition, there are cases of the development of the disease due to the use of oral contraceptives and drugs that reduce body weight. Frequent use of these types of means leads to abnormalities in the body, incl. and the proliferation of vascular endothelium.

Symptoms and degrees of pulmonary hypertension

Symptoms and degrees of pulmonary hypertension

To identify pathology at an early stage is not always possible, because a person simply does not notice any violations. One of the most prominent symptoms of pulmonary hypertension is a decrease in physical activity.

General weakness for unknown reasons often becomes the reason for going to the doctor, and as a result of the examination it turns out that such a serious disorder is present. Doctors share pulmonary hypertension according to degrees of severity, which correspond to certain symptoms:

1. Degree I:

  • rapid pulse;
  • exercise is easy to carry;
  • no additional signs.

2. Grade II:

  • human activity decreases;
  • dyspnea;
  • dizziness;
  • pain in the chest area.

3. Grade III:

  • a person feels comfort only when inactive;
  • all symptoms are aggravated by physical exertion.
Pulmonary heart development

Pulmonary heart development

4. Grade IV:

  • fatigue does not pass even after sleep;
  • symptoms are observed and in a state of rest;
  • hemoptysis;
  • pulmonary edema;
  • fainting;
  • swelling of the neck veins;
  • diffuse cyanosis (cyanosis of the skin);
  • any load leads to a sharp aggravation.

Pulmonary hypertension of 1 degree is manifested only in the form of frequent heartbeat. But an ordinary person does not attach any significance to this feature. Only a doctor can suspect something is wrong, and then with sufficient knowledge and experience.

More severe symptoms are characterized by grade 2 pulmonary hypertension. The more neglected the disease, the more often there is shortness of breath and dizziness, and fatigue sometimes takes a chronic form.

Diagnosis of the disease

Prerequisites for deep diagnostics are ECG readings. This method demonstrates abnormalities in the functioning of the heart, which in the first place suffers from hypertension. In general, a set of measures to identify the disease is as follows:

  1. Electrocardiogram. Reveal an overload of a right ventricle and other frustration.
  2. X-ray examination. The picture shows the transparency of the pulmonary fields on the periphery, the displacement of the cardiac borders in the right direction and other changes.
  3. Respiratory tests. Analyze the gas composition of exhaled air and lung volume.
  4. Echo-cardiography. Hypertension sets even at an early stage. It is used to determine the pressure in the pulmonary artery.
  5. Scintigraphy Using radioactive isotopes, a clear picture of the state of the pulmonary artery is obtained.
  6. Computed and magnetic resonance imaging . Used to clarify radiographic images.
  7. Heart catheterization. Provides information about blood flow and pressure inside the heart and surrounding vessels. Conducted to determine the feasibility of treatment.

Normal is considered the pressure inside the pulmonary artery at 25 mm Hg. (systolic) and 8 mm Hg (diastolic). In hypertension, these parameters exceed 30 and 15 mmHg. respectively.

Treatment of pulmonary hypertension

To overcome this disease is quite difficult, and sometimes - impossible. And yet there are drugs for the treatment of pulmonary hypertension, although their effectiveness largely depends on the stage of the disease.

But first and foremost, doctors recommend reducing the risks of complications and exacerbation of the disease:

  1. Rejection of pregnancy. The circulatory systems of the woman and the fetus are closely related, so an increased load on the heart in pulmonary hypertension can even lead to the death of the expectant mother.
  2. Power Restriction. In the diet of cores should not be fatty and salty foods. In addition, the daily rate of water is only 1.5 liters.
  3. Physical exercises are performed as much as possible, but you should not overdo it.
  4. Vaccination. Vaccinations against common diseases will avoid infection and exacerbation of pulmonary hypertension.

Equally important is the psychological support of the patient. Of course, patients are different: one disease is seen as a test of strength, the other - as hopelessness.

Support a desperate person is the task of relatives and friends. If a patient has no desire to fight for his life, then medicine will not help him.

Secondary pulmonary hypertension requires treatment, primarily of a primary disease. Therapy is sometimes delayed for years, because it is not so easy to stop the proliferation of the vascular endothelium. In most cases, doctors prescribe a course of special preparations, but they don’t give preference to any one remedy.

It is an integrated approach that is shown in this disease:

  • Endothelin receptor antagonists inhibit endothelial cell division.
  • Prostacyclins eliminate vasospasm and prevent blood clots. Indicated for use in the case of systemic disorders and even HIV infection.
  • Oxygen therapy saturates the blood with oxygen. In the later stages of the disease, up to 15 liters of gas are required daily.
  • Anticoagulants dilute the blood and facilitate its flow through the vessels.
  • Diuretic drugs remove fluid from the body, which reduces the load on the heart as a whole.
  • Natural glycosides are used to combat cardiac arrhythmias and vascular spasms.
  • Vasodilators are needed to increase the lumen in the capillaries and reduce the pressure in the pulmonary artery.
  • Nitric oxide is used for low treatment efficacy by other methods. The result is a decrease in pressure in the pulmonary artery system and in other vessels. Procedures are carried out for 5 hours daily for 2 weeks.

Surgical intervention

Treatment of pulmonary hypertension grade 1

Often, pulmonary hypertension provokes cyanotic heart disease, which cannot be managed by therapeutic methods.

In such cases, it makes sense to perform balloon atrial septostomy: a catheter cuts the septum between the atria and expands the resulting opening with a balloon. As a result, oxygenated blood enters the right atrium, which facilitates the patient's condition and reduces the symptoms of the disease.

In severe situations, a person may be recommended to have a lung and heart transplant. Such an operation is performed only in specialized medical institutions, however there are contraindications: liver and kidney dysfunction, cancer, HIV infection, etc.

In addition, a certain difficulty is the search for donor organs. And although such surgery is associated with a high risk to life, modern medicine successfully copes with transplantation.

Prevention of pulmonary hypertension

To prevent pulmonary hypertension is not easy due to unclear etiology of the disease. If a person has congenital heart defects, then sooner or later they will manifest themselves. However, one should not exacerbate the situation independently, because taking care of health is a personal task of each individual.

Preventive measures will reduce the risk of developing primary and secondary hypertension with a systematic approach:

  1. To give up smoking. It is necessary to saturate the blood only with useful gases.
  2. Choosing a harmless profession. Often, miners and builders suffer from chronic obstructive pulmonary disease ( COPD ), which provokes pulmonary hypertension. If you can not change the type of activity, then you need to pay maximum attention to occupational safety (protective masks, etc.).
  3. Strengthening immunity. In a strong body rarely fail. You need to regularly take vitamins, get enough sleep and eat right.
  4. Psychological comfort. Nervous disorders often become the cause of psychosomatic diseases, so negative energy should not be stored in oneself.
  5. Playing sports from youth creates prerequisites for the health of the soul and body throughout life.

Pulmonary hypertension is a rare but dangerous disease that can lead to death. Today's medicine offers a comprehensive medical treatment of the disease, although sometimes only an organ transplant will give a positive result.

Pulmonary hypertension in mcb 10

In the international classification of diseases ICD 10 disease is:

I00-I99 - Diseases of the circulatory system

I26-I28 - Pulmonary heart and impaired pulmonary circulation

I27 - Other forms of pulmonary heart disease

  • I27.0 - Primary Pulmonary Hypertension
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