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?

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!

Chronic Obstructive Pulmonary Disease or COPD for short is a respiratory disease that makes it increasingly difficult to breathe; the lungs stop functioning properly. There are mainly two categories of COPD which are emphysema and chronic bronchitis. The primary reason for COPD is longstanding exposure to substances such as cigarette smoke, chemical fumes and air pollutants that damage the lungs gradually.

Initially, the symptoms of COPD may be really mild but over time it may become extremely severe. These include symptoms such as:

Shortness of breath
Coughing with mucous formation
Wheezing or gasping
Tightness in the chest
Feeling tired constantly after doing normal daily activities or after exercising.
In the long run, the damages can prove to be permanent.

Of the two subtypes mentioned, bronchitis is when the airways become inflamed as well as narrowed. People suffering from bronchitis tend to produce sputum which is basically a combination of mucus and saliva.
And the other subtype, Emphysema is the condition when the air sacs in the lungs become affected. The air sacs degenerate and become baggy with lots of holes in it. This, in turn, traps air. This narrows the airways making it difficult to breathe. In COPD, there is a narrowing of the lungs because:

The lining of the airway becomes inflamed
The lining of the airways which is elastic flops
The tissues of the lungs become damaged so there is an exertion on the airway.
COPD, in the long run, can lead to a number of health complications such as heart disorders, lung cancer, respiratory infections, depression and high blood pressure. COPD is treatable but not curable because it is a life-long condition. The following are some of the treatment methods for COPD:

Oxygen Therapy- If you are experiencing low levels of oxygen then opting for a portable oxygen unit will be extremely beneficial.
Medication- Bronchodilators help in relaxing the airway muscles for comfortable breathing. These medications are usually taken via an inhaler. Other medications include corticosteroids, theophylline, vaccines and antibiotics/antivirals.
Surgery- Surgery is usually advised as the last step when the COPD condition has become so severe that all other methods of treatment have failed. This is, more possible, in the case of emphysema. There are mainly two surgical methods: one is bullectomy when the surgeons remove the damaged air sacs. The other method is lung volume reduction which removes the lung tissues that have become damaged.
Adopting certain lifestyle changes can provide relief for the time being. Such alterations include:

Quit smoking immediately, if you haven t already.
Try to avoid passive smoking as much as possible. Passive smoking is as damaging as firsthand smoking.
Give your body the daily dose of nutrition so that the immune system doesn t falter as well.

Better Living with COPD - A Patient Guide!

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

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!

COPD, short for Chronic Obstructive Pulmonary Disease, is an inflammatory disease of the lungs. The disease obstructs the flow of air in the lungs and subsequently causes difficulty in breathing. Prolonged exposure to cigarette smoke, gases or particulate matter can lead to this condition. The condition transcends all age brackets meaning it can affect anyone from young teenagers to aged adults. People who contract this disease are at an increased likelihood of developing cardiovascular conditions and lung diseases, in addition to a horde of other conditions.

Causes of COPD
1. The chief cause of COPD is smoking tobacco and being subjected to fumes from cooking and heating. A study estimated that in and around 25% of long-standing smokers develop symptoms of this condition. Yet, statistics show that COPD is often misdiagnosed until an elaborate evaluation is diagnosed.
2. Conditions like Emphysema and chronic bronchitis are also known to cause the disease. Your lungs depend on the intrinsic elasticity of the air sacs and bronchial tubes that help facilitate the passage of air through the lungs. Chronic Obstructive Pulmonary Disease causes these passages to lose their elasticity thus rendering them partially ineffective.

Symptoms of COPD 
The symptoms of COPD do not appear until the lungs are significantly damaged and the condition tends to deteriorate if smoking persists. Apart from coughing and production of sputum, other apparent symptoms include:
1) Difficulty in breathing
2) Stiffness and tightness of chest
3) A persistent cough
4) Fatigue and weakness
5) Weight loss
6) Frequent allergic reactions of the respiratory glands

Along with the aforementioned symptoms, patients who are diagnosed with COPD are likely to experience bouts of exacerbation, during which their symptoms heighten and tend to grow worse for several days.
Although anyone can contract the condition, certain people are at an increased risk of condition. Such risk factors include:
a) Chronic smoking
b) A medical history of asthma
c) Exposure to chemicals and dusts
d) Weakening of the immune system with increasing age
e) Heredity
If you experience or entertain symptoms or suspicions of this disease, consulting a pulmonologist is duly advised.

Causes and Symptoms of COPD

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