Pulmonology: Pulmonary hypertension — Diagnosis and conservative treatment. Treatment
Pulmonary hypertension (PH) is a life-threatening condition caused by increased pressure in the pulmonary vasculature. The prevalence of this disease is 15 cases per 1 million people. It affects mainly women 30 to 40 years old; males are diagnosed with this disorder 4 times less frequently. Hemodynamic disorders threaten the development of the right ventricular failure, so all patients with PH require increased surveillance and continuous therapy.
Examination of patients is repeated every 3 months in order to assess the dynamics of the disease and effectiveness of the chosen treatment. The range of mandatory monitoring activities includes:
- Clinical examination. The physician listens to the heart sounds, examines the skin and limbs of the patient.
- ECG. The changes in the right ventricle are diagnosed.
- Echocardiography. It allows determining the condition of all vessels and chambers of the heart.
- Cardiopulmonary exercise test and 6-minute walk test. The lung ventilation and work of the heart during exercise is assessed.
- Right heart part catheterization. The probe is introduced into the heart chambers, through which the intracardiac pressure is measured.
The unscheduled studies are conducted upon deterioration of the patient’s condition.
PG treatment is aimed at suppression of symptoms and prevention of blood clots in the pulmonary artery. The basis of drug therapy is:
- Anticoagulants. They reduce the blood viscosity, prevent the formation of blood clots. Typically, the patients are prescribed warfarin. The drug must be taken subject to blood clotting monitoring.
- Vasodilators. They lower the pressure in the pulmonary vasculature. They are effective at early stages of the disease. Therapy begins with small doses, gradually increasing to the permanent ones.
- Diuretics. They lower the blood pressure and shortness of breath. They are recommended at the first signs of the right ventricular failure. Upon pronounced edemas, the drugs are prescribed in high doses.
- Oxygen. It is prescribed for severe right ventricular failure. By eliminating hypoxia, the drug improves the general condition of the patient.
When conservative methods prove to be inefficient, the surgical treatment is conducted.
If any PG version, the patients are recommended to limit their physical activity and treat the pulmonary infections actively.Hide
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