Pulmonary Hypertension

Pulmonary hypertension is a condition that causes a narrowing and/or a blockage of the blood vessels in the lungs. It leads to shortness of breath, chest pain, and other symptoms.

What is pulmonary hypertension?

Pulmonary hypertension (PH) is a condition that causes high blood pressure in your pulmonary arteries. These are the blood vessels that carry oxygenated blood from your heart to your lungs.

It’s a serious condition that restricts blood flow, narrows your pulmonary arteries, and makes your heart work faster to pump blood around your body.

Over time, pulmonary hypertension begins to damage the heart. While there's no cure, treatments can help you manage the condition and feel better.

Our lung specialists see patients with pulmonary hypertension in our purpose-built Lung Health centre, where they offer the most advanced care in both diagnostics and treatment.

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The symptoms of pulmonary hypertension often start as mild and slowly worsen– you might not notice them for months, or even years.

The signs to look out for include:

  • shortness of breath – this is usually the first symptom. It often starts during exercise, and eventually happens at rest, too

  • having no appetite

  • blue or grey skin – these changes may be harder or easier to see, depending on your skin colour

  • chest pressure, pain, or tightness

  • dizziness or fainting

  • fast pulse or a pounding heartbeat

  • fatigue

  • swelling in your ankles, legs, and tummy area

Pulmonary hypertension happens because of changes in the cells that line your pulmonary arteries. This causes the walls of the arteries to become stiff, swollen, and thick. 

The condition is split into 5 different groups, depending on what triggers these cell changes.

1. Pulmonary arterial hypertension (PAH)

The causes of PAH can include:

  • changes in a gene passed down through families, called heritable pulmonary arterial hypertension

  • using certain medicines or illicit drugs, including methamphetamine

  • heart conditions that are present at birth, such as a congenital heart defect

  • other health conditions, including scleroderma, lupus, and cirrhosis

2. Pulmonary hypertension caused by left-sided heart disease

The most common form of pulmonary hypertension. Triggers include:

  • left-sided heart failure

  • left-sided heart valve disease, including mitral valve or aortic valve disease

3. Pulmonary hypertension caused by lung disease

Triggers of pulmonary hypertension caused by lung disease include:

  • scarring of the lungs (pulmonary fibrosis)

  • chronic obstructive pulmonary disease (COPD)

  • sleep apnoea – a sleep disorder where breathing stops and starts during sleep

  • being at high altitudes for long periods of time

4. Pulmonary hypertension caused by blockages in the pulmonary artery

Causes of this type of PH include:

  • blood clots in the lungs that don't go away

  • tumours that block the pulmonary artery

5. Pulmonary hypertension triggered by other health conditions

Other health conditions that can cause PH include:

  • blood disorders, including polycythemia vera and essential thrombocythemia

  • inflammatory disorders, such as sarcoidosis

  • glycogen storage disease

  • kidney disease

  • Eisenmenger syndrome

In many cases, no cause is found, which is called idiopathic pulmonary hypertension.

Pulmonary hypertension often develops in people between the ages of 30 and 60. Getting older tends to increase the risk of developing PAH.

Other factors that can raise your risk of pulmonary hypertension are:

  • a family history of the condition

  • being overweight

  • smoking

  • blood-clotting disorders, or a family history of blood clots in the lungs

  • a history of being around asbestos

The symptoms of pulmonary hypertension are very similar to those of many other heart and lung conditions. It means several tests are usually needed to diagnose the condition and find the cause.

Tests that may be required in the diagnosis of pulmonary hypertension include:

  • blood tests

  • lung function and exercise tests

  • a chest x-ray

  • an electrocardiogram (ECG)

  • an echocardiogram

  • a cardiac MRI scan 

  • a CT scan

  • a ventilation-perfusion scan

  • an ultrasound of the liver

  • cardiac catheterisation

It’s not always possible to prevent pulmonary hypertension, especially if it runs in your family. But you may be able to lower your risk by:

  • creating an exercise plan

  • eating a heart-healthy diet – avoid processed foods, fast food, and other foods high in salt and saturated fat

  • not smoking or using tobacco products

  • taking medications for blood pressure and other conditions, if you need to

If left untreated, pulmonary hypertension may lead to serious complications, such as:

  • right-sided heart enlargement and heart failure – it causes the heart's right lower chamber to get larger as it works harder to pump blood through narrowed or blocked lung arteries. Over time, this heart chamber can fail

  • blood clots – PH increases the risk of blood clots in the small arteries of the lungs

  • irregular heartbeats (arrhythmias)

  • bleeding in the lungs – this can be life-threatening

  • pregnancy complications

While pulmonary hypertension can’t be cured, treatment can help reduce your symptoms and slow the progression of the condition. 

Options may include:

  • treating the underlying condition that’s causing PH

  • medications – such as anticoagulants (blood thinners), vasodilators, and diuretics

  • oxygen therapy

  • surgery

At Welbeck, our lung specialists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.

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London

1 Welbeck Street
Marylebone
London
W1G 0AR

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Frequently asked questions

Some types of pulmonary hypertension (PH) are rare, such as PAH, and PH caused by blood clots. Other types are much more common, especially PH caused by heart or lung problems. It’s thought PH may affect 1 in 100 people around the world.

Your lung specialist will be able to give you specific advice, but in general, you should reduce how much salt, sugar, saturated fat, and fast foods you eat. Instead, eat foods high in fibre (like whole grains, bran, fruits, and vegetables), potassium (like dried fruits, bananas, and oranges), and magnesium (like peanuts, tofu, and broccoli).

There are 4 main stages of PH, which are based on the symptoms you have and how well you go about your normal life. They include:

  • class 1 – when you don’t have any symptoms

  • class 2 – when you don’t have symptoms at rest, but you feel discomfort during household chores and climbing the stairs

  • class 3 – when you feel fine at rest, but it’s much harder to do normal tasks

  • class 4 – when you have troubling symptoms, even at rest

You can usually fly with PH, as long as a doctor or specialist has given you a letter stating you’re fit to fly. You may need supplemental oxygen to help you breathe during the flight, so let the airline know well in advance. You’ll also need travel insurance for your trip, to bring all your medication with you, and wear compression stockings, to help prevent deep vein thrombosis (DVT).

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