Pulmonary hypertension – Diagnosis and treatment

Pulmonary arteries carry deoxygenated blood from the heart to the lungs. High blood pressure in these arteries is called Pulmonary Hypertension, a chronic condition with no direct cure.

Therefore, Pulmonary hypertension treatment mainly focuses on treating underlying causes and preventing permanent damage to the pulmonary arteries.
The course of treatment for Pulmonary hypertension will depend on the severity of the disease. Depending on the intensity of the condition and damage to the pulmonary arteries, the top experienced doctors at Metro Hospitals would advise the following course of treatment-

1. Medications: Doctors will generally provide medications to manage the symptoms and slow down the progression of the disease. Different types of medications for pulmonary hypertension include:
   • Vasodilators
   • Calcium channel blockers
   • Anticoagulants
   • Medication to help manage hypertension and prevent heart failure
   • Medications to increase blood flow
   • Medication to help the heart beat stronger, pump more blood & control Arrhythmias
   • Medications to widen blood vessels
   • Diuretics
2. Lifestyle & Dietary changes: If the disease has not progressed to advanced stages, lifestyle and dietary changes can help prevent progression and manage symptoms. These would include managing weight, getting regular exercise, quitting smoking, etc. We have board-certified doctors with years of experience who will work with you to help you achieve these changes along with other lines of treatment.
3. Oxygen Therapy: We will provide oxygen therapy that involves providing higher concentrated oxygen given to the patient to treat pulmonary hypertension.
4. Atrial Septostomy: This is an open-heart surgery performed when medications are not effective enough. It is done to relieve the pressure on the right side of the heart.
5. Pulmonary Endarterectomy: It is a type of surgery performed on people with chronic thromboembolic pulmonary hypertension to remove existing blood clots from the pulmonary arteries (present in the lungs).
6. Balloon Pulmonary Angioplasty: It is a fairly recent procedure available at our hospital. It is usually performed when pulmonary endarterectomy is not suitable for certain patients. In this, a balloon is inserted into the arteries and inflated to restore blood flow.
7. Lung or Heart-Lung Transplant: It is performed only rarely as a last resort for patients with idiopathic pulmonary arterial hypertension.

Pre-procedure Preparations:

Spending on the type of treatment offered by our doctors, the patients will be guided to prepare for the procedure accordingly. If surgery has been prescribed following preparations will be recommended:

1. Medication: The doctors will prescribe certain medications, review your existing medications and may even stop some medications a few days before the surgery.
2. Lifestyle Changes: Our doctors will recommend certain dietary and lifestyle changes before the surgery to ensure successful outcomes of the surgery. You will be given the medications to prepare your body for heart surgery if required. Moreover, the doctors will ask you not to drink or eat anything for 8-12 hours before the surgery.
   Be sure to follow the doctor’s guidelines carefully to help relieve symptoms of pulmonary hypertension.
3. Recovery Planning: You will be guided to plan for your recovery well in advance. If you are going into surgery, it is recommended that you inform friends and family members and get their help during this time. You will need While our nursing staff will ensure that post the procedure, you are well taken care of; it is advised that you have someone close by your side to help you recover.

Benefits of Pulmonary Hypertension Treatment:

1. Helps relieve symptoms
2. Improves overall quality of life
3. Prevents the risk of heart failure
4. Reduce instances of Arrhythmia
5. Prevents the development of any further complications

Eligibility

Our doctors at Metro Hospitals will try their best to treat pulmonary hypertension holistically. Surgery will be prescribed only if necessary. Otherwise, mild symptoms will be treated with medications and prescribed lifestyle and dietary changes. If surgery is prescribed, it is only after thorough evaluation and testing of the extent of the disease. These common tests may include:

1. Blood tests
2. Chest X-ray
3. Electrocardiogram (ECG)
4. Echocardiogram
5. Right heart catheterisation
6. Computerised Tomography (CT).
7. Heart (cardiac) CT
8. Magnetic Resonance Imaging (MRI)
9. Lung (pulmonary) function test
10. Sleep Study (polysomnogram)
11. Ventilation/perfusion (V/Q) scan
12. Open-lung biopsy

Not all of the tests need to be performed for every patient. Our experienced doctors will determine which tests a particular patient will require depending on their condition.

Who is not eligible for Pulmonary Hypertension Treatment?

Most patients will be able to take the prescribed medications unless they are allergic or have some underlying conditions that may be affected by certain medications. In such a case, alternative medication will be prescribed. In case a patient needs surgery, here are a few things that may make them ineligible for the procedure:

• Ongoing active infections
• Allergies to anaesthesia or other required medications
• Additional medical conditions like cancer, diabetes, cholesterol, severe obesity etc.

Pulmonary Hypertension Treatment is an incurable condition. Therefore, our doctors will work closely with the patients to monitor their symptoms and help manage them through the most effective and least invasive methods wherever possible. The highly certified & experienced doctors at Metro Hospitals will answer all your queries patiently and keep you informed about your condition to help you throughout the treatment.