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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:
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Digoxin: Digoxin (Lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias.
- 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.
- 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.
- 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.
- 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.
- 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
- 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. If you wish to discuss about any specific problem, you can consult a Pulmonologist.
Dear Dr. What are the chances that through partner I can have uti infection. How to prevent it? Secondly, I have heard that eating too much lemon have adverse effect on sex life. I love lemons and I eat half lemon / day. Is it true?
My female friend have irregular period times and she suffers from irritation at private parts time to time, where also some times a pimple occurs. And moreover she often had secretion of fluid from vagina more than usual. Due to these problems she had body ache & got tired very often and not able to do much physical activities please give suggestion to identify and cure these problems.
Dear sir/ma'm, I was about to have sex with my gf, who is a virgin. I am disturbed and afraid bcz of many reasons. When I inserted into her with a slight force, it went inside and she felt huge pain. Since then it has been 3 days, she is not well, feeling headache, fever and lower stomach pain. After 3 months we're going to marry, I am 25 and she is 23. please help me. And then I will meet any sexologist if needed.
I am married and having 1 year old kid. We decided to for next kid after 3 years. I am using condom for sexual intercourse. My partner some times have hitching problem. Any other advice for avoiding pregnancy. Also during sexual intercourse sperm comes immediately during penetration. Pls advice for having increased time for sexual intercourse.
Eating oily like ghee butter and milk in last trimester is not good for my baby pls tell . I am 7 month pregnant and my 8 will soon started .will it harden my uterus and pls tell is it not good for normal delivery .
I had taken abortion pills in end of may (27) nd get negative results in june Also on june 29 I got my regular periods Bt in month of july my periods are skipped I chest on Dr. Advice bt my results are negative I have taken regestrone for 3 days 2 tablets a day Bt still my periods are absent Now wt should I do, One thing, my course of medicine is like- 1 mifepristone on 27 may 1 mifepristone on 28 may 1 misoprostol inserted in vagina on 29 may 2 tab of misoprostol on 30 may nd 1 june Nd 1 tab on 2 june This course is advised by my Dr. To terminate 4 week pregnancy Bt acc to my studies on net, I have taken double dose of pills Is my periods are absent due to this? Please help me.
Am a 24 year female. I have 2 children and now I want not get the pregnancy what is the best and safe way to control the pregnancy.
I had sex, took a contraceptive tablet after that. I got my first period on exact date but was for 3 days only (normal 4-5 days). Now 2nd period is getting delayed last month date was 23rd jan. Very much worried am I pregnant? Please help.
Hello lyb. Doc. To get conceive. On what alternate days. We have to do intercourse. My period usually. My cycle is 31-34 days. We are planning for baby. please suggest.
Doctor can prega news be used after 5-6 days of intercourse. Actually I had wet humping. But I am doubtful that if I am pregnant. Doctor please suggest me what shall I do?
I am trying to conceive from last 4 months but I am unable to conceive. What should I do? I have been married for 5 years and have a baby boy of 4 years I gave birth to son under C Section.
I have married 4 months ago my wife is very horny she insist me to have 3 times a day morning, evening and night as from one month she is doing it but from one week I am having a slight continues pain in my right side of kidney please help me is it safe and now what can I do to stop pain?
Ideally, undescended testis should be surgically replaced before 1 year of age .
After birth if testis is not in the sack then chances of malignant changes increase with every passing month.
Initially, hormonal therapy may be attempted but if no descent then surgery recommended before 1 year age.
Surgery+hormonal therapy us the best approach to management.
Risk with No Descent of Testis
*Risk of testicular malignancy*this persists to some extent even after descent
*Risk of infertility
*Psychological distress to the child
Successful detection before puberty though doesn't decrease risk of malignancy but helps in detecting changes if any easily.