What is the Treatment for Pulmonary Hypertension for 2022

What causes pulmonary arterial hypertension?

Some common underlying causes of pulmonary hypertension include high blood pressure in the lungs' arteries due to some types of congenital heart disease, connective tissue disease, coronary artery disease, high blood pressure, liver disease (cirrhosis), blood clots to the lungs, and chronic lung diseases like emphysema.

Is pulmonary artery hypertension serious?

Pulmonary hypertension is high blood pressure in the blood vessels that supply the lungs (pulmonary arteries). It's a serious condition that can damage the right side of the heart. The walls of the pulmonary arteries become thick and stiff, and cannot expand as well to allow blood through. What is the life expectancy of someone with severe pulmonary hypertension? While there's no cure for PAH, there are effective ways to manage the disease. The median survival [from time of diagnosis] used to be 2.5 years. Now I'd say most patients are living seven to 10 years, and some are living as long as 20 years.

Treatments for pulmonary arterial hypertension

There are many treatments for pulmonary arterial hypertension (PAH). Which treatment or combination of treatments you'll be offered will depend on a number of factors, including what's causing PAH and the severity of your symptoms. Treatments include:

anticoagulant medicines such as warfarin to help prevent blood clots
diuretics (water tablets) to remove excess fluid from the body caused by heart failure
oxygen treatment involves inhaling air that contains a higher concentration of oxygen than normal
digoxin can improve your symptoms by strengthening your heart muscle contractions and slowing down your heart rate
There are also a number of specialist treatments for PAH that help relax the arteries in the lungs and reduce the blood pressure in the lungs.

These medicines slow the progression of PAH, and may even reverse some of the damage to the heart and lungs.

Other treatments that are sometimes used are:

endothelin receptor antagonists such as bosentan, ambrisentan, and macitentan
phosphodiesterase 5 inhibitors sildenafil and tadalafil
prostaglandins epoprostenol, iloprost and treprostinil
soluble guanylate cyclase stimulators such as riociguat
calcium channel blockers nifedipine, diltiazem, nicardipine and amlodipine

The 3 types of surgery currently used are:

pulmonary endarterectomy is an operation to remove old blood clots from the pulmonary arteries in the lungs in people with chronic thromboembolic pulmonary hypertension
balloon pulmonary angioplasty is a new procedure where a tiny balloon is guided into the arteries and inflated for a few seconds to push the blockage aside and restore blood flow to the lung; it may be considered if pulmonary endarterectomy is not suitable, and has been shown to lower blood pressure in the lung arteries, improve breathing, and increase the ability to exercise
atrial septostomy a small hole is made in the wall between the left and right atria of the heart using a cardiac catheter, a thin, flexible tube inserted into the heart's chambers or blood vessels; it reduces the pressure on the right side of the heart, so the heart can pump more efficiently and the blood flow to the lungs can be improved