The main sign of pulmonary hypertension is an increase in pressure in the pulmonary artery (the norm in some cases is exceeded by two or more times). In most cases, this pathology is a secondary condition. However, if specialists are not able to determine the cause of its development, pulmonary hypertension is considered primary. With this type of disease, narrowing of the vessels with their subsequent hypertrophy is characteristic. An increase in pressure in the pulmonary artery causes an increased load on the right atrium, as a result of which violations in the functionality of the heart develop.
Many are interested in what should be normal pressure in the pulmonary artery?
Description
Most often, pulmonary hypertension is manifested by clinical symptoms such as discomfort in the chest, severe dizziness, shortness of breath with tension, periodic fainting, and fatigue. Diagnosis of the disorder is to measure pressure in the pulmonary artery. Therapy of pulmonary hypertension is carried out using vasodilator drugs. In some of the most severe cases, the patient is shown surgical intervention.
The norm and pressure gradient in the pulmonary artery will be considered below.
Possible pathologies
Quite often, pulmonary hypertension is a complication of certain diseases. Possible pathologies:
- Hypoventilation of the lungs.
- Cirrhosis of the liver.
- Myocarditis.
- Vein thrombosis of arteries, lung branches.
- Impaired lung function.
- Pathological changes in the atrial septum.
- Congestive heart failure.
- Mitral valve stenosis.
In this regard, if the pressure in the pulmonary artery deviates from the norm, it is important to immediately consult a doctor and undergo a full examination.
Norm
Normal indicators of blood pressure of the lungs are as follows:
- The average pressure in the pulmonary artery is normal - from 12 to 15 mm. Hg. Art.
- Diastolic - from 7 to 9 mm. Hg. Art.
- Systolic pressure in the pulmonary artery is normal - from 23 to 26 mm. Hg. Art.
These indicators should be stable.
What is the norm of design pressure in the pulmonary artery? In accordance with the recommendations adopted by WHO, the normal calculated systoles should be a maximum of 30 mm. Hg. Art. At the same time, the maximum diastolic pressure is 15 mm. Hg. Art. Pulmonary hypertension is diagnosed when the deviation of the indicator exceeds 36 mm. Hg. Art.
The norm of the estimated systolic pressure in the pulmonary artery is not widely known.
Symptoms of pulmonary hypertension
It is possible to determine the pressure in the pulmonary artery only by instrumental methods, since with a moderate form of pathology, symptoms practically do not appear - characteristic signs occur only when the disease becomes severe.
At the initial stages, a deviation from the norm of pressure in the pulmonary artery is manifested by the following symptoms:
- Shortness of breath appears, which worries a person in the absence of intense physical exertion and even at rest.
- Gradually, body weight decreases, and this does not depend on the quality of human nutrition.
- An asthenic disorder occurs, depression develops, severe weakness, lack of performance. It is worth noting that this condition does not depend on the time of day, on changes in weather conditions.
- A cough occurs regularly, with no discharge from the respiratory system.
- Hoarseness occurs.
- Discomfort in the abdominal cavity appears. A person experiences a feeling of pressure from within, heaviness. The reason for this symptom lies in the stagnation in the portal vein, which transfers blood to the liver.
- The brain is affected by hypoxia, which causes frequent dizziness and fainting.
- Gradually, tachycardia becomes noticeable on the neck and palpable.
Signs of disease progression
Over time, the disease progresses, pulmonary hypertension worsens and causes the following symptoms:
- When coughing, sputum is released with an admixture of blood, which indicates swelling in the lungs.
- Attacks of angina pectoris appear, accompanied by soreness in the sternum, an unreasonable sense of fear, severe sweating. Such symptoms indicate the development of myocardial ischemia.
- Atrial fibrillation develops.
- The patient experiences pain in the right hypochondrium. This condition occurs due to the fact that a number of pathologies of the circulatory system develop.
- The lower limbs swell severely.
- Ascites develops (a significant amount of fluid accumulates in the abdominal cavity).
At the terminal stage of the pathology, blood clots form in the arterioles, which can lead to increasing suffocation, heart attack.
Diagnosis of pulmonary hypertension
To identify the condition, a series of hardware studies should be carried out. These include:
- Roentgenography. It allows to identify excess throughput in the pulmonary fields, the displacement of the heart faces to the right, an increase in the roots.
- ECG. It allows to identify overloads on the right side, which are characterized by a pathological increase in the size of the ventricle, proliferation of the atrium. The onset of various forms of atrial fibrillation, extrasystole is characteristic. Deviation of pulmonary pressure from normal on echocardiography can be seen.
- Echocardiography (echocardiography). It is the most informative method for the diagnosis of hypertension, allows you to identify most of all disorders in the heart. In addition, hypertension can be seen on echocardiography even in the initial stages of development.
- Tests of the respiratory system, analysis of the level and amount of gas in the blood. This method is used to determine the severity of the pathology, the degree of respiratory failure.
- MRI CT These research methods allow you to get a high-quality picture, and the introduction of a contrast medium allows you to assess the state of the respiratory and cardiovascular systems.
- Scintigraphy. It is indicated for thromboembolism. In 90% of cases, the technique provides reliable data.
- Ultrasound This diagnostic technique allows you to determine the parameters of the heart chambers, wall thickness.
Pulmonary hypertension in childhood
Deviation of pressure in the pulmonary artery in children from the norm occurs against the background of congenital pathologies of blood vessels, heart. The disease manifests itself in children with frequent breathing, cyanosis. At an older age, the disease begins to progress, which is accompanied by the occurrence of circulatory failure - the liver increases, tachycardia develops, shortness of breath appears.
The most common abnormalities in systolic pulmonary artery pressure in childhood are the following congenital pathologies of the heart and blood vessels:
- One common heart ventricle.
- Open atrioventricular canal or Botall duct.
- The combination of a septal defect with transposition of the pulmonary artery and aorta.
- Large opening in the interventricular septum.
In addition, pulmonary hypertension in children can develop due to pulmonary hypoplasia against the background of a hernia of the diaphragm or due to the penetration of amniotic fluid or intestinal contents into the respiratory tract at the time of birth.
Provocative factors
The following factors contribute to the increase in pressure in the pulmonary arteries:
- Preeclampsia in the mother, the use of various medicines by the mother, toxicosis in late pregnancy.
- Infections of the newborn or fetus.
- Autoimmune pathologies.
- Generic hypoxia.
- Pneumonia.
- Vascular thrombosis.
- Bronchospasm.
- Hereditary predisposition.
The classic manifestations of pediatric arterial hypertension are as follows: palpitations, fainting, chest pain, cyanosis of the skin, weak weight gain, decreased appetite, tearfulness, irritability, lethargy, shortness of breath.
If primary signs of pulmonary hypertension are detected, the child should be immediately shown to a specialist, since this pathology is very dangerous in childhood.
Therapy of pulmonary hypertension
To stabilize the pressure in the pulmonary artery, drug therapy is prescribed, first of all. Preparations and treatment regimens should be determined by the doctor individually and only after a full examination.
Pulmonary hypertension is treated with drug and non-drug methods. Drug treatment involves the use of drugs in the following groups:
- Calcium antagonists. These substances are able to normalize the rhythm of the heart, relieve spasm in the vessels, relax the muscles of the bronchi, give the heart muscle resistance to hypoxia.
- Diuretics. Drugs help eliminate excess fluid from the body.
- ACE inhibitors. The impact of these drugs is aimed at narrowing the blood vessels, reducing the load on the heart muscle, reducing pressure.
- Antiplatelet agents. Reduce the adhesion of red blood cells and platelets.
- Nitrates. Against the background of their use, the load on the heart is reduced. The effect occurs as a result of the expansion of the veins located in the legs.
- Indirect anticoagulants. Contribute to a decrease in blood coagulability.
- Anticoagulants of the direct type. They help prevent blood clotting and, as a consequence, the development of thrombosis.
- Endothelin receptor antagonists. Preparations of this group have a pronounced vasodilating effect.
- Antibiotics. Indicated for use in the case of accession of bronchopulmonary infection.
- Bronchodilators. Contribute to normalization of lung ventilation.
- Prostaglandins. They have a number of positive effects on the body. For example, they contribute to the expansion of blood vessels, slow down the processes of formation of connective tissues, reduce damage to endothelial cells, and prevent the bonding of blood elements (red blood cells, platelets).
Non-drug methods for eliminating pulmonary hypertension
There are also non-drug methods of restoring the norm of pressure in the pulmonary artery:
- Exclusion of intense stress on the heart.
- Dosing of physical activity. It avoids the appearance of pain in the heart, shortness of breath, fainting.
- Exclusion of climbs to a great height (more than a kilometer).
- Reduced salt intake.
- Reduce fluid intake to 1.5 liters.
Operation
If the described methods are ineffective, the life-threatening pathology can be eliminated by surgical intervention, carried out in three ways:
- Atrial septostomy. It involves the creation of a small hole between the atria. As a result, the pressure in the atria and pulmonary arteries is reduced to normal.
- Thrombendarterectomy. It involves the removal of blood clots from blood vessels.
- Transplantation of lungs (lungs and heart). The main indications for such a procedure are hypertrophic changes in the muscles of the heart, insufficiency of the heart valves.
Conclusion
It is important to remember that it is necessary to consult a doctor immediately if symptoms of pulmonary hypertension occur. Attempts to independently control the pathology through the use of various medications can result in significant deterioration and, in some cases, death.
Arterial hypertension is a pathology, the therapy of which should be comprehensive. In addition, treatment should be carried out under the supervision of a specialist.