Pulmonary hypertension: symptoms, causes, treatment

Pulmonary hypertension is a generalized name for a group of diseases characterized by a progressive increase in pulmonary vascular resistance leading to right ventricular failure and, as a result, premature death. This disease was first diagnosed in 1891 by Dr. Ernst von Romberg, and in 1973 at the WHO meeting an attempt was made to classify pulmonary hypertension. First, pulmonary hypertension was divided into primary and secondary. Primary hypertension in turn was divided into obliterating, arterial, reticular and thromboembolic forms. Later, in 1998, at the second conference held in Evian-les-Bains, it was proposed to classify pulmonary hypertension on the basis of clinical manifestations. According to the latest classification, there are five types of this disease: venous, arterial, thromboembolic, hypoxic and mixed.

The development of pulmonary hypertension is due to a gradual narrowing of the lumen of medium and small pulmonary vessels. The result of this narrowing is the complete closure of blood vessels, increased pressure in the vessels of the lungs, the pumping function of the heart chambers deteriorates . Pulmonary hypertension belongs to a group of complex multidisciplinary diseases, and knowledge about them is constantly replenished.

Pulmonary hypertension: symptoms.

Patients complain of general weakness, increased fatigue, shortness of breath, constrictive pain and discomfort in the left half of the chest, fainting conditions, and swelling of the legs. Symptoms can vary in intensity and depend on the severity of the disease. There are four functional classes of pulmonary hypertension. The group with the first class of pulmonary hypertension includes patients experiencing difficulties with strong physical exertion; To the second class of hypertension are patients who feel normally at rest, but even with moderate loads they have shortness of breath, weakness, chest pain and dizziness. Patients with a third class of pulmonary hypertension experience the above symptoms even under household stress. The fourth class of pulmonary hypertension is classified in patients unable to withstand the slightest physical exertion, and even in peace they suffer from weakness and dyspnea.

An important place among the causes of pulmonary hypertension is the most frequent variant of lung disease - chronic bronchitis, which occurs in 90% of people who smoke. In addition, pulmonary hypertension is the most common complication in cardiac muscle damage in patients with heart defects suffering from coronary artery disease and inflammatory diseases of the myocardium. Also, this disease is often enough in patients with various autoimmune pathologies, such as rheumatoid arthritis, lupus erythematosus and scleroderma.

Pulmonary hypertension: treatment and prevention.

Treatment of such a serious disease as pulmonary hypertension is one of the most difficult tasks of medical therapists and cardiologists. Currently, a number of specialized centers for the treatment and research of this pathology have been created around the world. Treatment of this disease includes activities aimed at reducing the likelihood of worsening of the course of the disease. These include: prevention of pregnancy, vaccination against pneumococcal infection and influenza, controlled rehabilitation, psychosocial support and physical activity dosing.

The main goal in the treatment of pulmonary hypertension is to eliminate the cause of its occurrence, as well as to reduce blood pressure in the pulmonary artery, to prevent the formation of blood clots. The course of treatment includes:

- the reception of vasodilators, acting relaxing on the smooth muscle layer of the vessels. These include prazosin, hydralazine and nifedipine;

- reception of preparations-anticoagulants of indirect action, whose action is aimed at reducing the viscosity of the blood - acetylsalicylic acid, dipyridamoleal, etc .;

- inhalation of oxygen during hypoxia and severe dyspnea;

- taking diuretics.

In very severe cases, heart and lung transplantation is used.