Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of the heart. Learn more from Dr. Dina Darsaklis, Cardiology Director of Pulmonary Vascular Disease at Hartford Hospital.
Q: What is pulmonary hypertension? What are its causes?
A: Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart.
In one form of pulmonary hypertension, tiny arteries in your lungs, called pulmonary arterioles, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, and raises pressure within your lungs’ arteries. As the pressure builds, your heart’s lower right chamber must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and fail.
Overworked and enlarged, the right ventricle gradually becomes weaker, and loses its ability to pump enough blood to the lungs. This could eventually lead to the development of right heart failure.
Q: What are the symptoms of pulmonary hypertension? How is it diagnosed?
A: Pulmonary hypertension is a tricky disease in the sense that, in the beginning of the disease process, one of the only symptoms is usually shortness of breath with everyday activities, such as climbing stairs. Fatigue, dizziness, and fainting spells also can be symptoms. Swelling in the ankles, abdomen or legs, bluish lips and skin, and chest pain may occur later in the disease process, as strain on the heart increases.
Eventually, it may become difficult to carry out everyday activities as the disease worsens.
Q: What are some of the treatment options offered at Hartford Hospital to treat this condition?
A: A comprehensive team approach works best for patients. That is, a clinical combined front featuring a pulmonologist and a cardiologist. Much depends on the type of hypertension, as this will help determine the treatment. It can range from combined oral therapy to infusion pumps. Hartford Hospital is also participating in an international research study involving patients that suffer from pulmonary hypertension with left heart disease or HIV.
Q: Are there any new treatments on the horizon?
A: Yes. External infusion pumps have been used to deliver prostacyclins for this condition, but managing the therapy places a significant burden on patients, interferes with their daily activities, and runs a high risk of infections.
This past year, the FDA an Implantable System for Remodulin, a type of prostacyclin drug, for patients with pulmonary arterial hypertension. The benefit is that it’s implantable, and takes significant burden off of the patient.
Q: How does it work?
A: Surgeons insert the intravascular catheter through a vein, and connect the catheter to the pump in a pump pocket placed beneath the abdominal skin. The surgeon then uses the handheld programmer device to program and review the pump’s settings. Once the surgeon programs the pump, the medicine is injected through the pump tubing to the delivery site. The pump remains permanently implanted and the health care provider can refill the pump as needed.