The ONE organ responsible for high blood pressure.
What is pulmonary hypertension?Pulmonary hypertension (PH) is a disease characterized by abnormally high blood pressure in the small pulmonary arteries, which impedes the flow of blood to the lungs. To compensate, the right ventricle of the heart, which sends blood to the lungs for reoxygenation, must work harder. When it can no longer do so, breathing difficulties on exertion appear. At an advanced stage, the patient may develop heart failure, which is fatal in the short term if not managed.
CausesPulmonary hypertension may or may not be associated with a variety of conditions, including cardiovascular or pulmonary. Specialists distinguish five forms of the disease involving different mechanisms, corresponding to different causes.
Group 1:pulmonary arterial hypertension, or PAH. This rare and severe disease can be fatal in a few years. It is due to remodeling of the pulmonary artery wall, leading to its thickening. It often occurs without an identified cause (idiopathic PAH) or in a hereditary context (familial PAH), but can also be related to certain diseases such as congenital heart disease or HIV infection. It can also be induced by drugs or toxins.
Group 2: pulmonary hypertension due to left heart disease.
Group 3:Pulmonary hypertension associated with respiratory disease and/or hypoxia (lack of oxygen supply to the tissues). It results, for example, from chronic obstructive pulmonary disease (COPD), sleep-disordered breathing or developmental abnormalities.
Group 4:Pulmonary hypertension related to chronic thromboembolic disease. This is caused by blockage of the vessels by a blood clot.
Group 5:other causes: sarcoidosis, tumors compressing the vessels, chronic kidney disease...
DiagnosisThe diagnosis is based on a battery of tests that allow to evaluate the functioning of the heart and lungs.
Cardiac Doppler ultrasoundIn case of suspected pulmonary hypertension, cardiac ultrasound is performed to demonstrate elevated pulmonary arterial pressure and certain cardiac anomalies. It allows direct observation of the structures of the heart and their functioning. Coupled with the Doppler, it offers a visualization of the blood circulation.
Cardiac catheterizationCardiac catheterization is used to clarify the diagnosis. It is performed using a long flexible tube (catheter) inserted into a vein, which goes up to the heart and then to the pulmonary arteries. This test measures blood pressure in the atria of the heart, pulmonary artery pressure and blood flow. Various other tests are useful in the initial work-up:
- Six-minute walk test (to assess the extent of respiratory discomfort)
- Breathing function tests
- Lung x-ray
- Chest scan (CT scan)
- Blood tests...