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Primary Pulmonary Hypertension


Overview, Causes, & Risk Factors

Pulmonary hypertension refers to high blood pressure in the arteries that lead to the lungs. If no other cause can be found, the condition is called primary pulmonary hypertension.

What is going on in the body?

The pulmonary blood pressure is the pressure in the arteries in the lungs. This is not the same as the blood pressure that is measured in a doctor's office. Pulmonary pressure can only be measured by special tests, such as x-ray tests. The blood pressure in the pulmonary arteries can be high for many reasons. In some cases, no cause for the increased pressure is found. This is known as primary pulmonary hypertension, which is rare.

What are the causes and risks of the disease?

The cause of this rare condition is unknown. Some cases are thought to be inherited. This condition is most commonly seen in women between the ages of 20 and 40 years old.

The main risks of this condition are a weakening of the heart and death, both of which usually occur.


Symptoms & Signs

What are the signs and symptoms of the disease?

Primary pulmonary hypertension may cause the following symptoms:

  • gradually increasing shortness of breath, which is made worse by activity
  • fatigue
  • chest pain
  • a feeling of lightheadedness
  • fainting, or passing out
  • swelling in the legs
  • a cough that doesn't go away
  • palpitations, which are an unusual feeling of a strong, abnormal, or fast heartbeat
  • coughing up blood
  • a bluish tint to the skin, known as cyanosis

  • Diagnosis & Tests

    How is the disease diagnosed?

    Pulmonary hypertension is usually caused by other conditions. Extensive testing of the heart and lungs is needed to rule out other causes. These tests include blood tests, breathing tests, and special x-ray tests. In rare cases, a lung biopsy is done. This involves removing a piece of lung tissue with a special needle. The tissue can then be looked at with a microscope. If other causes cannot be found, a diagnosis of primary pulmonary hypertension is made.


    Prevention & Expectations

    What can be done to prevent the disease?

    There are no known ways to prevent this condition.

    What are the long-term effects of the disease?

    This disease causes severe weakening of the heart and leads to death. A person usually survives only 2 to 3 years after the diagnosis has been made.

    What are the risks to others?

    This condition is not contagious and poses no risk to others.


    Treatment & Monitoring

    What are the treatments for the disease?

    The only cure for primary pulmonary hypertension is a lung transplant to replace both lungs. Sometimes a heart transplant is also needed. Medications can be used to improve symptoms for a short time, but the person usually dies unless he or she receives a lung transplant.

    What are the side effects of the treatments?

    All medications have possible side effects. These may include allergic reactions and low blood pressure. Lung and heart transplants are major operations that can result in bleeding, infection, and death.

    What happens after treatment for the disease?

    A person will generally need lifelong treatment. If a lung transplant is not done, the types of medications and the doses will need to increase as the condition gets worse. If a transplant is done, the person will need to take strong medications, which have severe side effects. Intense monitoring is also needed after a transplant.

    How is the disease monitored?

    A person with primary pulmonary hypertension needs lifelong monitoring with blood tests, breathing tests, special blood pressure measurements, and various x-ray tests.


    Attribution

    Author:Adam Brochert, MD
    Date Written:
    Editor:Smith, Mary Ellen, BS
    Edit Date:08/08/00
    Reviewer:Eric Berlin, MD
    Date Reviewed:05/03/00

    Sources

    Harrison's Principles of Internal Medicine, 1998, Fauci et al.

    Cecil Textbook of Medicine, 1996, Bennett et al.


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