Pulmonary Arterial Hypertension: Pathophysiology, Symptoms and Treatment

Pulmonary Arterial hypertension is a type of blood pressure that creates consequences for arteries of lungs that are medically known as pulmonary arterioles. In this condition, capillaries are narrowed and devastated. This way it is harder for blood to flow with ease to the lungs, as it raises the pressure of lung arteries. The presence of this pressure makes it heart muscles to be weak and in some cases fail.

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Pathophysiology of PAH is not clearly identified as it is related to the vascular resistance and vascular pressure. It includes the reasons that are behind this specific disorder. Major consequences and rare effects are showed. Pathophysiology is referred as the disorder happening in the body as it is related to the characteristics of the specified disease. In the case of Pulmonary Hypertension, the pathophysiology of this specific disease is not identified because of the reasons of vascular resistance and pressure that is related to Pulmonary Hypertension. In some cases, the increased amount of pulmonary vascular resistance happens because of the obliteration of these vascular walls or pathologic vasoconstriction. This vasoconstriction is most of the times related to thromboxane and endotheline. With an increased pressure it is also responsible for the increase in the parts of pressures related to pulmonary and injuries that happen due to the presence of coagulation.  With these responsibilities, the nature of Pathophysiology changes and consequences such as platelet dysfunction, plasminogen, and fibrinopeptide happens (Maron Et al 2016).

PAH have various effects on the cardiopulmonary status of the patient. The issue of PAH is connected to the heart as it affects the activity of heart and increases the heart rate with time. These changes are clearly noticeable in the electrocardiogram reports of patient.

          Apart from an increased amount in pulmonary vascular resistance, the increase in pulmonary venous pressure is also happens. This mechanism is responsible for various dangerous medical conditions. These conditions are resulting harm in the left side of heart with the high rate of pressure in the left ventricle of heart (Maron Et al 2016). Apart from these major consequences, the other rare effects are included as the thickening of alveolar capillary walls and present edema.

            There are current cases of this disease and 15-20% of these cases are related to the cases of Pathophysiology. This leads to the impression that people are mostly affected by this disease because of genetic disorders as medically it is found in various researches that this is actually caused because of hereditary factors.

There are a wide range of signs and symptoms for PAH, by identifying these symptoms on time it becomes easier for the medical authorities to control the drawbacks behind this disease, as it is not possible to completely cure it.

               The included symptoms of Pulmonary Arterial hypertension are noticeable in the initial months of the development of this disease. Major included symptoms are short of breath, fatigue, dizziness, chest pain, swelling of body parts, bluish color of lips and skin, and increasing rate of pulse. With these symptoms there are some risk factors involved in the occurrence of this disease. Some of these risk factors include; risky for young adults, gain of weight at any stage of life, usage of continuous illegal drugs, intake of appetite fulfillment medications, and involved family history of hypertension (McLaughlin al 2015).

             Involved complications after the occurrence of this disease are; the right side of heart is enlarged from its original size as it has to put hard pressure for the purpose of pumping of the heart, so that blood is flowed easily from the blocked part of arteries.  In this process, the thickening of a wall is only for a temporary period of time. Development of blood clots is also considered as a dangerous factor of this disease. Development of blood clots in the parts where they are not needed. Number unnecessary clots are developed in the places where they are not needed. These clots travel to the arteries of lungs where they are not needed. However, it is possible to remove these clots if consulted on time. If any patient has already narrowed arteries then it is quite dangerous for patients of Hypertension (McLaughlin Et al 2015). Irregular heartbeats that are normally known as arrhythmia as they are created in the chambers of heart are an unsafe complication as arrhythmia is able to lead the patient towards dizziness and fainting occurrences. Hemoptysis has also seen when a patient is going through Pulmonary Arterial hypertension as it is easily noticed by the professionals that that patients in complicated conditions are suffering from bleeding into their lungs and later they are coughing out the blood. Bleeding out is considered as a seriously fatal condition. With these conditions and symptoms Arterial hypertension is divided into five different groups. Namely; Normal Pulmonary Arterial Hypertension, PAH caused by left sided heart disease, PAH caused by lung disease, PAH caused by chronic blood clots, and PAH caused by unknown reasons.

Traditional practice to treat the disease process includes three totally different steps; application of these steps depends on the patient history. The applicable steps include; prescribed medications, surgeries for serious medical cases, and home remedies to control the drawbacks.

It is traditionally not possible to cure PAH, as according to doctors it is quite impossible to completely cure this disease, but according to medical staff it is quite possible to improve this condition to slow down the process of this disease. The involved treatment is still considered as the most complex treatment. Medications involved are; Vasodilators, Endothelin receptor, Sildenafil and tadalafil, Calcium Channel blockers, soluble guanylate cyclase, Anticoagulants, Digoxin, Diuretics, and Oxygen therapy.  

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Apart from medications, treatment through surgery is also conducted, these included surgeries for PAH are; Atrial Septostomy and Transplantation. Other treatment that are used to diagnosis PAH is ventilation and perfusion (VQ) scan, during this procedure the patient is given contrast liquid in the IV  helping the blood flow in the lungs showing up clear in the monitor. Meanwhile, the ventilation part the patient will breathe in a medical gas it will determine how well the lungs take in the oxygen.

          The classifications of pulmonary hypertension are divided into four groups. Class I identifies the diagnosis at a minor stage with no available symptoms. Class II has no serious symptoms; however the patient has minor symptoms such as fatigue, breathing issues, and regular chest pain. Class III shows major symptoms that are not coming in between the physical activeness of an individual. Class IV shows that patient has symptoms that are present but not actively affecting the patient, however, they are able to become active and harm the patient physically (Maron Et al 2016).

After medical treatment, the recommended home remedies that could at least lessen the major symptoms connected to PAH. These home treatments include; resting for the ease of relieving pain, staying physically active by exercising, starting an alternative plan for quitting the habit of smoking, avoiding too much travel, and continuously joining follow up programs for the controlling this issue.

Normally, family genes have a vital role in having this disease and other reasons behind having this disease are; congestive failure of heart, presence of blood clots in lungs, aids, and usage of illegal drugs, heart defect by birth, lung diseases, and sleep apnea that is a sleeping disorder.

             Role of both current and traditional practices for PAH is similar as both forms of practice have the responsibility of controlling this issue. These practices include pathophysiology, screening, clinical presentation, conventional therapies, and investigational therapies. Hazards of these practices include; nausea, vomiting, inflammation of lungs (in rare patients), alveoli damage, and inflammation. The benefit include controlling breathlessness, stable the stamina, and overcomes depression.

References

• Arena, R., Cahalin, L. P., Borghi-Silva, A., & Myers, J. (2015). The effect of exercise training on the pulmonary arterial system in patients with pulmonary hypertension. Progress in cardiovascular diseases, 57(5), 480-488.
• Diagnosing and Treating Pulmonary Arterial Hypertension. (Last Updated: March 13, 2018). The treatment for PAH is very complicated and depends on many factors. Retrieved from: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/pulmonary-arterial-hypertension/diagnosing-treating-pul-arterial-hypertension.html
• Maron, B. A., &Galiè, N. (2016). Diagnosis, treatment, and clinical management of pulmonary arterial hypertension in the contemporary era: a review. Journal of the American Medical Association cardiology, 1(9), 1056-1065.
• Maron, B. A., &Galiè, N. (2016). Pulmonary Arterial Hypertension Diagnosis, Treatment, and Clinical Management in the Contemporary Era. Journal of the American Medical Association cardiology, 1(9), 1056.
• McLaughlin, V. V., Shah, S. J., Souza, R., &Humbert, M. (2015). Management of pulmonary arterial hypertension. Journal of the American College of Cardiology, 65(18), 1976-1997.
• Pulmonary arterial hypertension. (2019). In CareNotes. Truven Health Analytics. Retrieved from https://linkgalecom.lscsproxy.lonestar.edu/apps/doc/A587017713/HRCA?u=nhmccd_main&sid=HRCA&xid=dc0b03f7