How Is Pulmonary Hypertension Treated?
Pulmonary hypertension (PH) has no cure, but
treatment may help relieve symptoms and slow the progress of the disease.
PH is treated with medicines, procedures, and other
therapies. Treatment will depend on what type of PH you have and how severe it
is. (For more information, see "Types of Pulmonary
Hypertension.")
Group 1 Pulmonary Arterial Hypertension
This type of PH includes PH that's inherited, that
has no known cause, or that's caused by certain conditions. Treatment for group
1 pulmonary arterial hypertension (PAH) includes medicines or medical
procedures.
Medicines
If you have group 1 PAH, you may need medicines to
relax the blood vessels in your lungs and reduce excess cell growth in the
blood vessels. As the blood vessels relax, more blood can flow through
them.
Examples of these medicines include
phosphodiesterase-5 inhibitors, prostanoids, endothelin receptor antagonists,
and calcium channel blockers.
To find out which of these medicines will work best,
you'll likely have an acute vasoreactivity test. This test shows how the
pressure in your pulmonary arteries reacts to certain medicines. This test is
done during
right
heart catheterization.
Medical and Surgical Procedures
If you have group 1 PAH, you may need one or more of
the following procedures.
Atrial septostomy. For this
procedure, a thin, flexible tube called a catheter is put into a blood vessel
in your leg and threaded to your heart. The tube is then put through the wall
that separates your right and left atria (the two upper chambers of your
heart). This wall is called the septum.
A tiny balloon on the tip of the tube is inflated to
create an opening between the atria. This procedure relieves the pressure in
the right atria and increases blood flow. Atrial septostomy is rarely done in
the United States.
Lung transplant. A lung transplant
is surgery to replace a person's diseased lung with a healthy lung from a
deceased donor. This procedure may be used for people who have severe lung
disease that's causing PAH.
Heartlung transplant. A
heartlung transplant is surgery in which both the heart and lung are
replaced with healthy organs from a deceased donor.
Group 2 Pulmonary Hypertension
Group 2 PH is caused by conditions that affect the
left side of the heart, such as
mitral valve disease. Treating these conditions also will help treat PH.
Treatments may include lifestyle changes, medicines, and surgery.
Group 3 Pulmonary Hypertension
Group 3 PH is linked to lung conditions, such as
COPD
(chronic obstructive pulmonary disease) and interstitial lung disease. Group 3
PH also may be linked to certain sleep disorders, such as
sleep
apnea.
If you have this type of PH, you may need oxygen
therapy. This treatment raises the level of oxygen in your blood. You'll likely
get the oxygen through soft, plastic prongs that fit into your nose. You can
get oxygen therapy at home or in a hospital.
Your doctor also may recommend other treatments if
you have an underlying lung disease.
Group 4 Pulmonary Hypertension
This type of PH is due to blood clots in the lungs,
blood clotting disorders, or
sickle
cell anemia. If you have this type of PH, your doctor will likely prescribe
anticoagulants, or "blood thinners." These medicines prevent clots from forming
or from getting larger.
In some cases, surgery is used to remove scarring in
the pulmonary arteries due to old blood clots.
Group 5 Pulmonary Hypertension
Various diseases and conditions cause group 5 PH.
Examples include
sarcoidosis,
Langerhans cell histiocytosis, and
lymphangioleiomyomatosis
(LAM). This type of PH also may be due to an object, such as a tumor, pressing
on the pulmonary blood vessels.
This type of PH is treated by treating its
cause.
All Types of Pulmonary Hypertension
Several treatments may be used for all types of PH.
These treatments include:
- Diuretics, or "water pills." These medicines help
reduce fluid buildup in your body, including swelling in your ankles and
feet.
- Blood-thinning medicines. These medicines help
prevent blood clots from forming or getting larger.
- Digoxin. This medicine helps the heart beat
stronger and pump more blood. Digoxin is sometimes used to control the heart
rate when certain abnormal heart rhythms occur, such as
atrial
fibrillation or atrial flutter.
- Oxygen therapy. This treatment raises the level
of oxygen in your blood.
- Physical activity. Regular activity may help
improve your ability to be active. Your doctor can help you create an exercise
plan that's safe for you.
Research on new treatments for PH is ongoing. These
treatments offer hope for the future. Talk to your doctor about whether you
should consider participating in research studies. |