The main symptom of pulmonary hypertension is an increase in pressure in the pulmonary artery (the norm in some cases is exceeded two or more times). In most cases, this pathology is a secondary condition. However, if experts are unable 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, resulting in abnormalities in the functionality of the heart.
Many people wonder what the normal pressure in the pulmonary artery should be?
Description
Pulmonary hypertension is most commonly manifested by clinical symptoms such as chest discomfort, severe dizziness, dyspnea on exertion, intermittentfainting, fatigue. Diagnosis of the disorder is to measure the pressure in the pulmonary artery. Pulmonary hypertension is treated with vasodilators. In some of the more severe cases, surgery is indicated for the patient.
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:
- Lung hypoventilation.
- Cirrhosis of the liver.
- Myocarditis.
- Thrombosis of the veins of the artery, branches of the lungs.
- Impaired lung function.
- Pathological changes in the interatrial 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.
Norma
Normal lung blood pressure readings are as follows:
- Average pressure in the pulmonary artery is normal - from 12 to 15 mm. rt. st.
- Diastolic - 7 to 9 mm. rt. st.
- Systolic pressure in the pulmonary artery is normal - from 23 to 26 mm. rt. st.
These indicators should be stable.
What is the normal design pressure in the pulmonary artery? In accordance with the recommendations adopted by WHO, normally calculated systoles should be a maximum of 30 mm. rt. Art. At the same time, the maximumdiastolic pressure is 15 mm. rt. Art. Pulmonary hypertension is diagnosed when the deviation of the indicator exceeds 36 mm. rt. st.
The norm of the estimated systolic pressure in the pulmonary artery is little 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 appear only when the disease becomes severe.
At the initial stages, abnormal 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.
- Weight gradually decreases, and this does not depend on the quality of human nutrition.
- An asthenic disorder occurs, depression develops, severe weakness, lack of efficiency. It is worth noting that this state does not depend on the time of day, on changes in weather conditions.
- Regular cough with no respiratory secretions.
- Hoarseness occurs.
- There is discomfort in the abdominal cavity. A person experiences a feeling of pressure from within, heaviness. The reason for this symptom lies in congestion in the portal vein, which transmits blood to the liver.
- The brain is affected by hypoxia, which causes frequent dizziness andfainting.
- Gradually becomes noticeable on the neck and palpable tachycardia.
Signs of disease progression
As the disease progresses, pulmonary hypertension worsens and causes the following symptoms:
- Coughing produces bloody sputum, indicating swelling in the lungs.
- Attacks of angina pectoris appear, accompanied by soreness in the sternum, an unreasonable feeling of fear, severe sweating. Such symptoms indicate the development of myocardial ischemia.
- Atrial fibrillation develops.
- The patient is experiencing pain in the right hypochondrium. This condition occurs due to the fact that a number of pathologies of the circulatory system develop.
- Lower limbs are very swollen.
- 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:
- X-ray. Allows you to identify excess throughput in the lung fields, displacement of the cardiac faces to the right, an increase in the roots.
- EKG. Allows you to identify overloads on the right side, which are characterized by a pathological increase in the size of the ventricle, growth of the atrium. Characteristic is the attackvarious forms of atrial fibrillation, extrasystoles. Pulmonary pressure abnormalities can be seen on echocardiography.
- Echocardiography (EchoCG). It is the most informative method for diagnosing arterial hypertension, it allows you to identify most of all disorders in the heart. In addition, arterial hypertension can be seen on echocardiography even at the initial stages of development.
- Respiratory system tests, analysis of the level and amount of gases 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 agent allows you to assess the state of the respiratory and cardiovascular systems.
- Sentigraphy. 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, the 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 enlarges, tachycardia develops, shortness of breath appears.
The most common congenital abnormalities of pulmonary artery systolic pressure in childhood are:heart and blood vessels:
- One common cardiac ventricle.
- Open atrioventricular canal or Botall duct.
- Combination of a septal defect with transposition of the pulmonary artery and aorta.
- A large hole in the interventricular septum.
In addition, pulmonary hypertension in children can develop due to pulmonary hypoplasia due to a herniated diaphragm or due to penetration of amniotic fluid or intestinal contents into the respiratory tract at the time of birth.
Provoking factors
The following factors contribute to an increase in pressure in the pulmonary arteries:
- Maternal pre-eclampsia, maternal drug use, late pregnancy toxemia.
- Infection of the newborn or fetus.
- Autoimmune pathologies.
- Birth hypoxia.
- Pneumonia.
- Vascular thrombosis.
- Bronchoconstriction.
- Hereditary predisposition.
Classic manifestations of childhood hypertension are as follows: palpitations, fainting, chest tenderness, cyanosis of the skin, poor weight gain, decreased appetite, tearfulness, irritability, lethargy, shortness of breath.
If primary signs of pulmonary hypertension are detected, a child should be immediately shown to a specialist, since this pathology is very dangerous in childhood.
Therapy for pulmonary hypertension
To stabilize the pressure in the pulmonary arteryprescribe, first of all, drug therapy. Drugs and treatment regimens should be determined by the doctor on an individual basis and only after a complete examination.
Pulmonary hypertension is treated with pharmacological and non-pharmacological methods. Drug treatment involves the use of drugs of 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, and give the heart muscle resistance to hypoxia.
- Diuretics. Drugs help to remove excess fluid from the body.
- ACE inhibitors. The impact of these drugs is aimed at vasoconstriction, reducing the load on the heart muscle, reducing pressure.
- Antiaggregants. Helps eliminate agglutination of red blood cells and platelets.
- Nitrates. Against the background of their use, the load on the heart is reduced. The effect comes as a result of the expansion of the veins located in the legs.
- Indirect anticoagulants. Helps reduce blood clotting.
- Direct type anticoagulants. They help prevent blood clotting and, as a result, the development of thrombosis.
- Endothelin receptor antagonists. The drugs of this group have a pronounced vasodilating effect.
- Antibiotics. Indicated for use in case of accession of a bronchopulmonary infection.
- Bronchodilators. Contribute to the normalization of lung ventilation.
- Prostaglandins. They have a number of positive effects on the body. For example, they contributevasodilation, slow down the processes of formation of connective tissues, reduce damage to endothelial cells, prevent the adhesion of blood elements (erythrocytes, platelets).
Non-drug treatments for pulmonary hypertension
There are also non-drug ways to restore the normal pressure in the pulmonary artery:
- Exclusion of intense stress on the heart.
- Dosing physical activity. Allows you to avoid the appearance of pain in the heart, shortness of breath, fainting.
- Exclusion of high altitude climbs (more than a kilometer).
- Reduce s alt intake.
- Reducing fluid intake to 1.5 liters.
Operation
If the described methods are ineffective, a life-threatening pathology can be eliminated by surgical intervention, carried out in three ways:
- Atrial septostomy. It involves creating a small hole between the atria. As a result, the pressure in the atria, pulmonary arteries decreases to normal.
- Thrombendarterectomy. It involves the removal of blood clots from the vessels.
- Lung transplant (lung 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 to seek medical attention if symptoms of pulmonaryhypertension is needed immediately. Attempts to contain the pathology on your own 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 complex. In addition, treatment should be carried out under the supervision of a specialist.
