Pulmonary Vascular Disease in simple form can be defined as any medical condition that affects the blood vessels between the heart and lungs. The process of oxygenation of blood takes place in the following way. Blood deprived of oxygen comes from the tissues of the body through the veins to the right side of the heart which then pumps this blood through the pulmonary arteries to the lungs which oxygenates the blood. The blood then returns to the left side of the heart where it goes to various parts of the body through the arteries. Any sort of blockage or damage to this whole path of the blood causes pulmonary vascular disease.
What are the causes of pulmonary vascular disease?
Causes of pulmonary vascular disease are variable and depend on the blood vessels in the lungs which are affected. Pulmonary Vascular Disease is divided into various categories which are as follows:
- Pulmonary Arterial Hypertension: This is a medical condition in which there is increased blood pressure in the pulmonary arteries. This disease is usually caused by lung diseases, autoimmune diseases, or heart failure.
- Pulmonary Venous Hypertension: This is a medical condition in which there is increased blood pressure in the pulmonary veins. This condition is usually caused by congestive heart failure.
- Pulmonary Embolism: This is a medical condition in which a blood clot which breaks from the deep vein gets pumped into the lungs from the heart.
- Chronic Thromboembolic Disease: In rare instances, pulmonary embolism is not reabsorbed by the body and instead causes other vessels to get diseased.
The symptoms of pulmonary vascular disease are dependent on which vessels are affected, how much damage has been affected to the lungs etc. The symptoms also depend on the underlying cause of pulmonary vascular disease.
How is pulmonary vascular disease diagnosed?
- Pulmonary Arterial Hypertension: The main symptom of this medical condition is progressive shortness of breath, chest pain, syncope with activities.
- Pulmonary Embolism: The main symptom of this condition is shortness of breath, chest pain, and rapid heart rate.
- Pulmonary Venous Hypertension: The symptoms of this disease condition are shortness of breath due to the congestive heart failure with progressive worsening with lying flat, uncontrolled blood pressure, presence of edema.
Depending on an individual's signs and symptoms, if the treating pulmonologist suspects presence of pulmonary vascular disease, then the pulmonologist may conduct the following tests to confirm the diagnosis.
- CT scan: This will generally detect the presence of pulmonary embolism which is a cause of Pulmonary Vascular Disease
- Perfusion Scan: This test determines how the lung is functioning when it comes to the filling up of air in the lungs.
- ECG: This study may determine the presence of congestive heart failure, heart valve disease, or other cardiac conditions.
- Right Heart Catheterization: This test is done to diagnose the presence of pulmonary arterial hypertension.
- Chest X-ray: This will reveal presence of enlarged pulmonary arteries suggesting presence of pulmonary arterial hypertension.
Pulmonary Vascular Disease is basically treated depending on the cause of it.
Pulmonary Embolism: Pulmonary embolism is basically treated with blood thinners. The most commonly used medications are heparin, Lovenox and Coumadin.
Chronic Thromboembolic Disease: Surgical procedure may be required for serious conditions of thromboembolic disease. Blood thinners may also be beneficial. A medication called Adempas has shown efficacy in people who cannot have surgery in improving their exercise tolerance.
Pulmonary Arterial Hypertension: Different medications can be used to reduce the blood pressure like Tracleer, Revatio, and Flolan etc.
Pulmonary Venous Hypertension: Since this condition is basically caused due to congestive heart failure hence appropriate treatment for congestive heart failure is important. Medications that can be used are Lasix, Aldactone, lisinopril, Lopressor, Norvasc, and Imdur etc.
If pulmonary vascular disease is caused due to an autoimmune condition then treating them with medications like prednisone, Imuran, and Cytoxan are beneficial.