Find out more about our Academic Medical Centre and efforts in Academic Medicine
Find out more about what JOAM do to support AM initiatives
Academic Medicine Executive Committee (AM EXCO)
Our appointed ACP leaders within the respective 15 ACPs
Guidelines, forms, and templates for Academic Medicine.
Pulmonary hypertension refers to high blood pressure in the lungs. It is a complex health condition and a relatively rare disease that affects people of different ages and ethnic groups.The rare lung disorder occurs when the blood pressure in the pulmonary arteries rises far above normal levels and the walls of the pulmonary arteries become thicker. There are many different types of pulmonary hypertension and sometimes, the cause is unknown.The detailed pulmonary hypertension processes are:
The common symptoms may include:
The symptoms of pulmonary hypertension are similar to those of other more common heart and lung problems. For this reason, diagnosis for pulmonary hypertension can be challenging and patients and doctors might overlook the condition until symptoms become severe. Further investigation is needed for an accurate diagnosis.
There are three causes for this abnormal narrowing:
Any of these changes in the body will make it difficult for blood to pass through the lungs. When that happens, the heart is forced to work very hard, resulting in the eventual weakening of the heart muscle and the loss of its ability to pump blood efficiently.There are several subtypes of pulmonary hypertension and they are categorised according to various causes ranging from genetic mutations to unknown causes.
In the early stages of the disease, a patient’s physical examination results may appear almost normal. To establish a diagnosis, doctors may order a series of tests to measure the lung pressure and the function of the patient’s heart and lungs. These tests are done at the same time to accurately narrow down the heart condition(s) causing the symptoms.
Even though there is no known cure for or prevention against pulmonary hypertension, the condition is still treatable.According to the American Lung Association, approximately 50 per cent of people diagnosed with pulmonary hypertension die within five years. For those whose condition is left untreated, the average survival is shortened to about three years.Even with treatment, the high blood pressure in the lung arteries will continue to worsen and make daily activities more difficult. Adopting lifestyle modifications, however, may help patients with pulmonary hypertension get through their daily routine.Cardiologists refer to the World Health Organization (WHO) Functional Classification to identify the severity of pulmonary hypertension in patients and decide on suitable treatments.
Functional status is a person’s ability to perform daily activities and is ranked from Class I (no limitations) to Class IV (unable to perform any physical activity). Below are the brief descriptions of the four NYHA functional classes.
Treatments for pulmonary hypertension, such as medications and surgery, are aimed at relieving symptoms, improving quality of life, and slowing down the disease progression. Doctors will also treat the underlying disease for patients whose pulmonary hypertension is caused by another medical condition. In addition, patients will need to change their lifestyle when their symptoms become worsen or when their daily activities are limited
There are several types of medications available for the treatment of pulmonary hypertension. They are mainly formulated to reduce the workload of the heart and improve blood flow through the lung vessels. Doctors may prescribe the medications based on the patients’ severity of the condition and how well they respond to treatment.
The medications typically prescribed for pulmonary hypertension include:
Doctors may recommend procedural or surgical treatment for pulmonary hypertension patients based on many factors. These procedures and surgeries include:
Pulmonary hypertension is a lifelong condition, thus patients with the condition may need to modify their living space and daily activities when symptoms worsen. They may also need assistance around the house due to their limitations. Lifestyle modifications for pulmonary hypertension patients include: