Pulmonary hypertension mainly occurs due to narrowing of the arteries of the lungs as a result of which the flow of blood is restricted. In this kind of condition, blood fails to carry oxygen to your heart and thus your heart gets adversely affected. The blood pressure of your body will get increased to a great extent if this situation remains untreated, thus leading to bdreadful consequenses, specifically situation like heart failure, serious pulmonary diseases, blood clots in lungs and congenial heart defects, etc.

There are certain forms of pulmonary hypertension, which are serious in nature and worsen with time, so much so that they are even fatal at times. It also includes forms which are non curable in nature, however, in order to improve the quality of life, symptoms can be reduced with proper treatment. The treatment for pulmonary hypertension is often complex and it takes some time to find the most appropriate treatment and requires extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. However, when pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible.

Common treatments for pulmonary hypertension:

Medications

1. Blood vessel dilators (vasodilators): vasodilators open narrowed blood vessels. They are one of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (flolan, veletri). The drawback to epoprostenol is that the effect lasts only for few minutes. This drug is continuously injected through an intravenous (iv) catheter via a small pump that you wear in a pack on your belt or shoulder.

2. Ventavis: another form of the drug, iloprost (ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs.

3. Treprostinil (tyvaso, remodulin, orenitram): it is another form of the drug, which can be given four times a day and can be inhaled or can be taken as an oral medication and can also be administered through injection.

4. Endothelin receptor antagonists: these medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring.

6. Sildenafil and tadalafil: sildenafil (revatio, viagra) and tadalafil (cialis, adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily.

6. High-dose calcium channel blockers: these drugs help relax the muscles in the walls of your blood vessels. They include medications, such as amlodipine (norvasc), diltiazem (cardizem, tiazac, others) and nifedipine (procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them.

7. Soluble guanylate cyclase (sgc) stimulator: soluble guanylate cyclase (sgc) stimulators (adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea.

8. Anticoagulants: your doctor is likely to prescribe the anticoagulant warfarin (coumadin, jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking.

9. Digoxin: digoxin (lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias.

10. Diuretics: commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs.

11. Oxygen: your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy.

Surgeries

1. Atrial septostomy: if medications don't control your pulmonary hypertension, this open heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart.

2. Lung transplantation: in some cases, a lung or heart lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension.

Reducing complications

1. The complications need to be reduced by taking proper health care. Healthy diet needs to be taken regularly along with proper medications. Smoking should be stopped and exercising sessions should be attended daily without any fail

2. Overweight or obesity needs to be controlled properly for reducing the complications. Specialized caring strategies need to be maintained for avoiding severe kinds of health complications that are quite annoying.

Pulmonary Hypertension: How to Treat It?

COPD, also known as Chronic Obstructive Pulmonary Disease is a chronic medical condition that triggers extensive damage to the lungs, interfering with its functioning. In COPD, the lungs and the air sacs or the alveoli undergo severe inflammation that gives rise to a host of complications including wheezing, shortness of breath and other related breathing troubles. While an early medical assistance is instrumental in proper management and treatment of COPD, in most cases, the associated symptoms and discomfort appear at a later stage (when the lungs have already undergone damage and inflammation). Thus, a proper awareness about COPD is necessary. In this article, we will discuss some important points related to COPD to help people understand the condition better.

While there can be a plethora of triggers, two of the medical conditions that elevate the incidence of COPD are Chronic Bronchitis and Emphysema. The bronchial tubules functions as a carrier transporting the air (oxygenated and deoxygenated) from the lungs to the different body parts and vice versa. 

In case of Chronic Bronchitis, the lining of these tubules undergo severe inflammation. 
In the case of Emphysema, the inner walls of the alveoli may rupture resulting in deleterious consequences including breathlessness.
For long people were of the opinion that COPD only affects people who smoke. However, various surveys suggest that COPD does affect non-smokers as well. While smoking does make a person more susceptible to the condition (COPD as well as Chronic Bronchitis and Emphysema), other factors such as chronic and severe neonatal lung ailments or prolonged exposure to the harmful gases and lung irritants can also act as triggers.

Though the incidences of COPD are relatively higher in people above 45 years, the young adults or the middle-aged can also be affected. Also, COPD is not limited to males and can affect females as well. Some of the symptoms associated with COPD include chest tightness, wheezing, breathlessness, chronic cough (often with mucus). These symptoms are quite similar to those of Asthma with people often confusing between the conditions. Thus, a proper diagnosis is vital. Spirometry is a lung test used in the diagnosis of COPD. This test evaluates the functioning of the lungs by measuring the amount of air inhaled and exhaled.

When we talk about the treatment or management of COPD, quitting smoking does improve the condition. For people with breathing troubles and chronic cough, the Bronchodilators (can be long-acting or short-acting Bronchodilators depending on the extent of the discomfort) comes as a great relief. The use of corticosteroids (inhaled) can go a long way to alleviate the inflammation of the airways.

In extreme cases with reduced oxygen reaching the blood, a person may need Oxygen Therapy to improve the condition. Of late the Pulmonary rehabilitation program have been benefiting people in dealing with COPD better. The program involves an amalgamation of counselling sessions to educate the people about the diet and nutrition, precautions to be followed along with some healthy lifestyle changes.

COPD - Things You Must Always Remember!

Copd, which is short for chronic obstructive pulmonary disease, is a severe form of lung disease that is characterized by increased breathlessness and obstruction of airflow from the lungs. People who are suffering from copd are at an increased risk of developing lung cancer, heart diseases and many other conditions. It includes progressive lung diseases such as chronic bronchitis, emphysema, few forms of bronchiectasis and refractory (non-reversible) asthma. The former two are the most common conditions contributing to copd. 

Chronic bronchitis induces inflammation in the airway that carries air to the lungs and fills it with mucus. This either completely blocks the airway or narrows it, causing difficulty in breathing. However in emphysema, the air sacs inside the lungs which inflate and deflate as you breathe in and out, lose their elasticity due to which less air comes in and goes out leaving you breathless.

The best way to treat copd is to quit smoking. Your doctor may also prescribe you medications or ask you to enroll in a lung rehab program. 
Causes:
1. Smoking
Smoking is one of the most common causes of copd. This is because smoking is known to destroy the stretchy fibers in people's lungs and irritate the airways. Even passive smoking is unhealthy. About 90% of the people having copd are current or former smokers. 
2. Genetics
Some individuals suffer from copd even after refraining from smoking. Genes might be at the helm of copd in such a case. Aatd i. E. Alpha -1 antitrypsin deficiency, is a protein in the lungs, the lack of which is one of the most common genetic factor causing emphysema. 
3. Environmental factors
Breathing in harmful pollutants present in your environment is also one of the causes of copd. Fumes, dust or certain chemicals are a few examples of harmful lung irritants. Organic cooking fuel may also cause copd. Exposing yourself to the aforementioned environmental factors for a prolonged period of time increases your risk of developing copd substantially. 

Symptoms:
1. Shortness of breath especially after exercising
2. Wheezing
3. Tightness in your chest
4. Unintended weight loss
5. Lack of energy
6. Frequent respiratory infections
7. Wheezing
8. Cough accompanied by mucus

Diagnosis:
1. Physical exam where your doctor monitors the functioning of your lungs. 
2. Questioning about your past health (smoking or other harmful lung irritants).
3. Spirometry and other breathing tests.
4. Chest x-rays and other tests to eliminate other problems which could be causing your symptoms.

All About COPD!

Chronic Obstructive Pulmonary Disease, abbreviated as COPD, is an umbrella term which refers to the group of lung infections and diseases that include emphysema, chronic bronchitis, and diseases of the small airways. Most people feel breathlessness, which is caused due to impairment of gaseous exchange that happens because of prolonged damage to the lungs over a period of time.

Symptoms such as fatigue, reduced tolerance to exercise, muscular dysfunction, breathlessness even after simple tasks like walking, anxiety, panic, depression, and mood disorders are associated with major chronic disorders of the respiratory system.

Pulmonary Rehabilitation:

Physiotherapy is an effective intervention to treat patients suffering from COPD. It is the part of a formal supervised, multidisciplinary, and an intensive Pulmonary Rehabilitation Program that helps in treating manifestations of the conditions like COPD and Asthma. It consists of exercises to improve and maintain good lung capacity, resistance training, aerobic exercises, and support to behavioural and lifestyle changes for promoting self- efficacy. Your physiotherapist will choose from the different techniques and positions used to remove the unwanted excess sputum from the lungs and airways. The main purpose of the Pulmonary Rehabilitation is to help in improving the psychological and physical conditions of the pulmonary patients, along with training them for health enhancement techniques. Also, it should be noted that Pulmonary Rehabilitation is the cornerstone of care for patients suffering from COPD that uses integrated care by exploring underutilized opportunities.

Benefits of Pulmonary Rehabilitation: 

There are well-researched evidences of the improvement in the capacity of exercising, less breathlessness and fatigue, better control over condition, and an overall improvement in the quality of life of the patients suffering from COPD and Asthma.

Also, undergoing Pulmonary Rehabilitation lowers the rate of admissions, and re-admissions in hospitals due to recurrence of the symptoms and the related conditions.

It has also been reported that if Pulmonary Rehabilitation is properly undertaken, there is nearly no need for systematic health review to check COPD.

Pulmonary Rehabilitation, being a comprehensive program, helps in restoring fitness and easy breathing through breathing techniques, nutrition, exercise, relaxation, emotional support, medications, self-management, and other strategies for a better life, mainly by helping the lungs and the heart to function better.

How It Works?

Exercise is the key to any Pulmonary Rehabilitation Program for helping the lungs and the heart to function better and adjust to the condition. Some of the following exercises can be recommended based on the medical history of the patient:

1. Lower Body Exercise focuses on the workout of legs via running on a treadmill or climbing the staircase for rigorous training.

2. Upper Body Exercise includes working up the muscles of the arm and the chest by tasks as simple as lifting arms against gravity.

3. Breathing Exercise helps people with weak breathing and increasing their breathing and lung capacity.

4. Strength Training helps in building endurance and better stamina through activities like weight-lifting.

Other than exercise, Pulmonary Rehabilitation Program focusses on helping patients build an understanding of their situation and amend their lifestyles accordingly. This includes helping them understand their medication plan, teaching them to use their inhalers right, quitting smoking, consuming a healthy and balanced diet, and other methods as may be suitable based on their specific condition. Also, they are made aware of their symptoms so that if there is any recurrence, it can be immediately reported to the concerned health professional. They are trained through counseling to manage and deal with panic, anxiety, and depression caused due to their condition.

Take Away: Pulmonary Rehabilitation Program is an effective intervention and the cornerstone of care for improving the psychological and physical conditions of the pulmonary patients, along with training them for health enhancement techniques. It helps in treating manifestations of the conditions like COPD and Asthma.

Pulmonary Rehabilitation For COPD & Asthma!

COPD stands for Chronic Obstructive Pulmonary Disease and is generally used to describe a broad category of diseases. These include chronic bronchitis, emphysema, non-reversible asthma as well as some forms of bronchiectasis. All of these diseases, however, can be prevented from getting worse by taking similar measures as the causes of these diseases are very similar.

Here are the ways to prevent COPD exacerbations:
1. Cleanliness: It is crucial that you do not allow infections to set in. Infections are probably the worst type of exacerbation possible in COPD. All you need to do to prevent infection is to take a little care to ensure good hygiene. Wash your hands often and do not allow people with colds or flu to come close to you.

2. Take vaccines: Make sure your flu and pneumonia shots have not been missed.

3. Take medicines: It is crucial that medicines for your lungs are taken on schedule, if you have COPD. The possible medicines which you could take if your doctor prescribes it includes inhaled beta-agonists, steroids and anticholinergics.

4. Spirometry: Doctors often recommend the use of the portable Spirometry device, Spirometer, in case of COPD. Spirometers check the condition of the lungs by measuring various parameters to see how well the lungs are working. Spirometers can easily measure FEV1, a parameter which measures how much air can you blow out in one second. This is especially great if you do not know whether your condition has exacerbated or not.

5. Corticosteroid: It is another type of medicine used, which can prevent COPD exacerbations. In its place, even inhaled beta-agonists or anticholinergics can also be used.

Preventing COPD Exacerbations!

Chronic Bronchitis is a result of inflamed bronchioles (pipes carrying air to alveoli or balloons) that can produce mucus and lead to coughing and difficulty in breathing. When smoking causes inflammation of the bronchioles, constriction or squeezing takes place. This results in wheezing because air is travelling through narrowed tubes.

Emphysema, in short, is basically a dead lung. As smoke travels farther down your respiratory tract, the air sacs in your lungs (alveoli), start popping out or dying. Your bank of alveoli gets depleted over time as you continue your habits. You will notice as you increase your heart rate whether its by running or walking a flight of stairs this activity requires your red blood cells to move faster through the alveoli and have less time to receive oxygen from the lung. This leads to having less oxygen on red blood cells whose job is to deliver oxygen to the rest of the body.

Symptoms

In COPD, Both the airways(pipes) and lung parenchyma are affected by the disease and airflow limitation is progressive. COPD has been predominantly seen in patients above 40-yearold and frequent smokers.

The symptoms indicative of COPD are as follows:

 

1) Chronic cough - Also referred to as smoker's cough, the cough is relentless and does not subside with regular cough treatment. This is one of the first indications of COPD.
2) Mucus buildup - There is constant built up of mucus which gets expelled during coughing. The person never feels completely clear of mucus, and the regular cough expectorants do not help relieve the symptoms.
3) Fatigue associated with limited activity - As noted earlier, the reduced capacity of the organs limits their activities. Therefore, regular activities like walking short distances or climbing stairs can induce fatigue.
4) Shortness of breath - The above fatigue is associated with shortness of breath, even with small physical exertion. A person with COPD will see marked tiredness and reduced ability to perform routine chores and feel a tightness in the chest.
5) Wheezing - Passage of air through the obstructed air tubes produces a whistling sound or wheezing. It is more pronounced when there is mucus accumulation in the airways.

Rarely, Frequent respiratory infections, more frequent flu attacks, swelling of the feet and ankles, cardiovascular disease, weight loss, and morning headaches.

Treatment 

While there is no cure for COPD, once it sets, the following are some ways to slow its progression and reduce severity of the symptoms:

1) Bronchodilators - Dilate the air tubes and ease flow of air
2) Corticosteroids - Help reduce inflammation and thereby improve airflow through the tubes
3) Flu vaccination - Helps curb the frequent flu attacks
4) Antibiotics - To contain infections
5) Pulmonary rehabilitation - A combination of breathing exercise and patient education to improve lung function.
6) Oxygen therapy - In very severe cases, oxygen may be required.
7) Lifestyle changes - Eating healthy foods, preventing exposure to dust and smoke, quitting smoking, breathing exercises, bi-annual medical check-ups to monitor lung functions are essential.

Knowing that you have COPD is the first step towards managing COPD, which can be managed effectively.

COPD Is Broken Down To Clinical Scenarios - Chronic Bronchitis & Emphysema!

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