Concept
Pulmonary hypertension
Overview
Pulmonary hypertension (PH or PHTN) is a condition of increased blood pressure in the arteries of the lungs. Symptoms include shortness of breath, fainting, tiredness, chest pain, swelling of the legs, and a fast heartbeat. The condition may make it difficult to exercise. Onset is typically gradual.
According to the definition at the 6th World Symposium of Pulmonary Hypertension in 2018, a patient is deemed to have pulmonary hypertension if the pulmonary mean arterial pressure is greater than 20mmHg at rest, revised down from a purely arbitrary 25mmHg, and pulmonary vascular resistance (PVR) greater than 3 Wood units.
The cause is often unknown. Risk factors include a family history, prior pulmonary embolism (blood clots in the lungs), HIV/AIDS, sickle cell disease, cocaine use, chronic obstructive pulmonary disease, sleep apnea, living at high altitudes, and problems with the mitral valve. The underlying mechanism typically involves inflammation and subsequent remodeling of the arteries in the lungs. Diagnosis involves first ruling out other potential causes. High cardiac output states, such as advanced liver disease or the presence of large arteriovenous fistulas, may lead to an elevated mean pulmonary artery pressure (mPAP) greater than 20 mm Hg despite a pulmonary vascular resistance (PVR) less than 2 Wood units, which does not necessarily indicate pulmonary vascular disease.
As of 2022 there was no cure for pulmonary hypertension, although research to find a cure is ongoing. Treatment depends on the type of disease. A number of supportive measures such as oxygen therapy, diuretics, and medications to inhibit blood clotting may be used. Medications specifically used to treat pulmonary hypertension include epoprostenol, treprostinil, iloprost, bosentan, ambrisentan, macitentan, and sildenafil, tadalafil, selexipag, riociguat. Lung transplantation may be an option in severe cases.
The frequency of occurrence is estimated at 1,000 new cases per year in the United States. Females are more often affected than males. Onset is typically between 20 and 60 years of age. Pulmonary hypertension was identified by Ernst von Romberg in 1891.
Overview adapted from Wikipedia (CC BY-SA 4.0; see the article history for authors).
Possible passages
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These disorders are called tetanus and opisthotonus, by reason of the tension which accompanies them. The cure of them is difficult; relief is in most cases given by fever supervening. The white phlegm, though dangerous when detained within by reason of the air-bubbles, yet if it can communicate with the outside air, is less severe, and only discolours the body, generating leprous eruptions and similar diseases…
Plato, Timaeus
States what Pulmonary hypertension is.
In the first place the waters are, for the most part, hard and cold. The men must necessarily be well braced and slender, and they must have the discharges downwards of the alimentary canal hard, and of difficult evacuation, while those upwards are more fluid, and rather bilious than pituitous. Their heads are sound and hard, and they are liable to burstings (of vessels?) for the most part. The diseases which…
Hippocrates, The genuine works of Hippocrates, Vol. 1
States what Pulmonary hypertension is.
About noon we began the tedious ascent of the Peuquenes, and then for the first time experienced some little difficulty in our respiration. The mules would halt every fifty yards, and then the poor willing animals after a few seconds started of their own accord again. The short breathing from the rarefied atmosphere is called by the Chilenos “puna;” they have most ridiculous notions concerning its origin. Some say…
Charles Darwin, Narrative of the surveying voyages of His Majesty's Ships Adventure and Beagle, Vol. 3 [of 3]
States what Pulmonary hypertension is.
Philosophers who discussed Pulmonary hypertension
Related ideas
Place in the tradition
Part of Robert C. Solomon.