Pulmonary Hypertension

It is completely different from the systemic high blood pressure measured from the arm; it is the increase in pressure and narrowing of the blood vessels strictly within the network running from the heart to the lungs.

Although a rare disease, chronic lung diseases (COPD), severe sleep apnea, a history of pulmonary embolism (clots), and valve insufficiencies on the left side of the heart can increase the pressure in these vessels, leading to the condition.

The heart's right chamber is responsible for pumping blood to the lungs. When lung vessels narrow and pressure rises, the right heart is excessively strained to pump against this high pressure. Over time, it thickens, enlarges, and fails (Cor Pulmonale).

Initially, there is mild shortness of breath only when walking up an incline. As the disease progresses, inability to breathe at rest, a feeling of fainting (syncope), palpitations, blueness of the lips (cyanosis), and severe fluid accumulation (edema) in the legs/abdomen occur.

Echocardiography (Heart Ultrasound) shows enlargement of the right heart and estimates the pressure. For a definitive diagnosis and precise pressure measurement, a Right Heart Catheterization (Angiogram), which reaches the right side of the heart through the groin, is mandatory.

Classic blood pressure medications do not work. Expensive and specific drugs/pumps (Endothelin antagonists, PDE5 inhibitors, etc.) that dilate the lung vessels are used. Patients are provided with continuous oxygen support. In end-stage cases unresponsive to medication, a Heart-Lung transplant is necessary.