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 or Chronic Obstructive Pulmonary Disease is a lung disease wherein, it gets difficult for a person to breathe due to thickening and inflammation of airways. World COPD day is being celebrated on 16th November, in order to, raise  wareness about COPD. It is a group of progressive lung diseases, the most common ones of which are emphysema and chronic bronchitis. Emphysema destroys your lungs  air sacs while bronchitis leads to the inflammation and narrowing of your bronchial tubes.

Symptoms of COPD

The early symptoms of COPD include occasional shortness of breath, especially after physical exercise, mild and recurrent cough and having the urge to clear your throat many times. You may start avoiding physical activities eventually. Other symptoms, which follow include wheezing, chest tightness, chronic cough with mucus, an urge to clear mucus from the lungs, frequent flu, colds and fatigue.

Factors behind it
Smoking accounts for being the major cause of COPD in developed countries. Commonly, people over the age of 40 with a history of smoking are affected with COPD. The more you smoke, more are your chances of getting the condition increase. Exposure to chemicals and harmful fumes may also cause COPD. Long-term exposure to polluted air and inhaling dust are other causes. The deficiency of a protein called alpha-1-antitrypsin is also said to cause COPD.

Diagnosis
COPD is diagnosed on the basis of several tests and examinations. They include spirometry, which is a noninvasive test for assessing lung function, imaging tests such as a chest X-ray or CT scan which provides an image of the lung for observation. An arterial blood gas test is also carried out for measuring blood oxygen levels.

Treatment
The treatment options for COPD include the following:

Medication: Bronchodilators are used for relaxing the muscles of your lungs  airways which simplify breathing. They are taken via inhalers. Glucocorticosteroids may be added to reduce inflammation.
Oxygen therapy: When your blood oxygen levels are low, oxygen is given via masks and nasal prongs which help you to breathe better.
Surgery: Surgery is carried out in the case of severe COPD or when other treatment methods fail. Bullectomy is a common surgical procedure used, in which the large air sacs or  bullae  are removed from the lungs. The lung volume reduction surgery is also carried out in which damaged lung tissues are removed. Lung transplant is required in extreme cases.
Lifestyle changes: You need to make some lifestyle changes to alleviate the symptoms of COPD which include the following:
Quit smoking in case you are a regular smoker.
Avoid any form of second-hand smoke and chemical fumes.
Consume all the essential nutrients required by your body.
Consult a doctor about your exercise patterns.
In case you experience any symptom of COPD, you should consult a doctor immediately for quick diagnosis and proper treatment.

World COPD Day Special - Facts You Should Know About COPD

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:

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. 
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. 
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:

Shortness of breath especially after exercising
Wheezing
Tightness in your chest
Unintended weight loss
Lack of energy
Frequent respiratory infections
Wheezing
Cough accompanied by mucus
Diagnosis:

Physical Exam where your doctor monitors the functioning of your lungs. 
Questioning about your past health (Smoking or other harmful lung irritants).
Spirometry and other breathing tests.
Chest x-rays and other tests to eliminate other problems which could be causing your symptoms.

World Chronic Obstructive Pulmonary Disease Day - Know More About COPD!

Chronic obstructive pulmonary disease is a long-term condition of the lungs where the flow of air to the lungs is restricted (obstructed). Symptoms include cough and breathlessness. The condition is most often caused by smoking and the most important treatment is to stop smoking. Inhalers are commonly used to ease symptoms. Other treatments such as steroids, antibiotics, oxygen, and mucus-thinning (mucolytic) medicines are sometimes prescribed in more severe cases, or during a flare-up (exacerbation) of symptoms.

What causes COPD?
Smoking is by far the biggest risk factor for COPD. The lining of the airways becomes inflamed and damaged by smoking. Cigarette smoking is the biggest risk factor.

Air pollution may cause some cases of COPD, or make the disease worse. Air pollution can be indoor air pollution or outdoor air pollution. Indoor air pollution seems to be involved in more cases of COPD than outdoor air pollution. Indoor air pollution includes fumes from indoor fires or stoves, and dust, fumes or chemicals present in some workplaces. The combined effect of exposure at work to air pollutants and smoking increases the chances of developing COPD.

A small number of people have a hereditary (genetic) risk of COPD due to very rare protein deficiencies that can lead to lung, liver and blood disorders. (The condition is called alpha 1 antitrypsin deficiency. Less than 1 in 100 cases of COPD are due to this.


COPD symptoms-


Cough is usually the first symptom to develop. It is produced with phlegm (sputum). It tends to come and go at first, and then gradually becomes more persistent (chronic). You may think of your cough as a 'smokers cough' in the early stages of the disease. It is when the breathlessness begins that people often become concerned.
Breathlessness (shortness of breath) and wheeze may occur only when you exert yourself at first. For example, when you climb the stairs. These symptoms tend to become gradually worse over the years if you continue to smoke. Difficulty with breathing may eventually become quite distressing.

Sputum - the damaged airways make a lot more mucus than normal. This forms sputum. You tend to cough up a lot of sputum each day.

Chest infections are more common if you have COPD. A sudden worsening of symptoms (such as when you have an infection) is called an exacerbation. Wheezing with cough and breathlessness may become worse than usual if you have a chest infection and you may cough more sputum. Sputum usually turns yellow or green during a chest infection. Chest infections can be caused by germs called bacteria or viruses. 
Other symptoms of COPD can be vaguer. Examples are weight loss, tiredness and ankle swelling.

What is the difference between COPD and asthma?


COPD and asthma cause similar symptoms - in particular difficulty breathing (breathlessness). However, they are completely different diseases. Briefly:

In COPD there is permanent damage to the airways. The narrowed airways are fixed, and so symptoms are persistent (chronic). Treatment to open up the airways is therefore limited.

In asthma, there is inflammation in the airways which makes the muscles in the airways narrow (constrict). This is temporary so the narrowing comes and goes. So, the symptoms tend to come and go, and vary in severity from time to time. Treatment to reduce inflammation and to open up the airways usually works well.

COPD is more likely than asthma to cause an ongoing cough with phlegm (sputum).

Waking at night with breathlessness or wheeze is common in asthma and uncommon in COPD.

COPD is rare before the age of 35, whilst asthma is common in under-35s.

There is more likely to be a history of asthma, allergies, eczema and hay fever (so-called atopy) in people with asthma.

Do I need any tests?

The most common test used in helping to diagnose the condition is called spirometry. This is a breathing test. You will be asked to breathe or blow into a small machine called a spirometer which will measure how well your lungs are working. This test can help make a diagnosis of COPD.


A chest X-Ray show signs of COPD and can be used to help exclude other serious conditions (including lung cancer). Occasionally, a special CT scan of the chest - high-resolution CT - is needed. A blood test to make sure you are not anemic is often helpful.

A pulse oximeter is a device which can be clipped on to your finger. It measures your heart rate (pulse) and the amount of oxygen in your circulation (oxygen saturation). Lower levels than normal tend to be found in people who have COPD, especially if you have a flare-up (exacerbation) of your symptoms.

COPD treatment-

Smoking cessation is the most important step towards treatment.
Inhalers

The main treatments are medications given in devices called inhalers. The medicine within the inhaler is in a powdered form which you breathe in (inhale). The medicines in standard inhalers reach the lungs better if used with a spacer device. Inhalers include one, two or even three types of medicines. They may include:


A bronchodilator agent - this is a medicine which opens up (dilates) the airways. Some work quickly but don't last very long; others are longer-acting.
A steroid - these reduce the inflammation in the airway, thereby reducing the swelling. This, in turn, adds to the space available for air to pass.
A medicine which helps to dry up the secretions produced by the airways.
Home oxygen
This may help some people with severe symptoms or end-stage COPD. It does not help in all cases. Unfortunately, just because you feel breathless with COPD it does not mean that oxygen will help you. Great care has to be taken with oxygen therapy. Too much oxygen can actually be harmful if you have COPD.
Regular follow up in OPD is an essential part of treatment success.

Chronic Obstructive Pulmonary Disease - Know More About It!

Myth: COPD is an incurable chronic lung disease mainly affecting the aged people (above 60 years).
Fact: There is no denying the fact that COPD is indeed a chronic disorder that severely affects the lungs and its functioning. However, with timely diagnosis and treatment, the condition and the deleterious consequences can be managed and controlled significantly. Since COPD triggers breathing problems (the airflow from the lungs gets obstructed), the use of bronchodilators, oxygen therapy or corticosteroids can be highly beneficial. Though COPD is rare among young adults, the condition can affect people in their late 30's or early 40's as well.

Myth: COPD only affects people who smoke.
Fact: Smoking is one of the triggers for COPD, but the condition can also affect people who have never smoked in their lifetime. Factors such as neonatal chronic lung disease or prolonged exposure to substances that cause lung irritation and damage (toxic industrial fumes and chemicals) can play a pivotal role in triggering COPD. COPD can also be a genetic predisposition.

Myth: People with COPD should avoid exercise and physical activities.



Fact: Mild to moderate exercise (especially breathing exercise) are indeed helpful and go a long way in the effective management of COPD. Exercising regularly (for 20-30 minutes or as the doctor recommended) help to lower the blood pressure and improve the circulation that provides fruitful results for people with breathing problems. However, doctors do advise people with shortness of breath to avoid strenuous exercise.

Myth: COPD only affects the lungs.
Fact: With time and left unmanaged and untreated, COPD acts as a catalyst making a person more susceptible to heart ailments. In some cases, the condition can also trigger depression and anxiety.

Myth: In the case of COPD, giving up on smoking will not produce any positive results.
Fact: Giving up on smoking may not help to reverse the damage that has already been caused by COPD. However, quitting smoking along with proper medications and lifestyle changes does help to control the condition better. In some instances, there were also significant improvements in the associated symptoms (such as shortness of breath, fatigue, wheezing, a chronic cough).

Myth: COPD is another name for Asthma.
Fact: Many people confuse COPD with Asthma. Though some symptoms may appear identical (such as wheezing, shortness of breath), the conditions are different and so are their treatments. In case you have a concern or query you can always consult an expert & get answers to your questions.

COPD - Are You Aware Of These Myths & Facts?

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