Pulmonary Hypertension

What is pulmonary hypertension?
Primary pulmonary hypertension (PPH) is a rare lung disorder in which the blood pressure in the pulmonary artery rises far above normal levels for no apparent reason. The pulmonary artery is a blood vessel carrying oxygen-poor blood from the right ventricle (one of the heart's pumping chambers) to the lungs. In the lungs, the blood picks up oxygen, then flows to the heart's left side, where the left ventricle pumps it to the rest of the body through the aorta.
Hypertension is a medical term for abnormally high blood pressure. Normal average pulmonary artery pressure is about 14 mm Hg at rest. In patients with PPH, the average blood pressure in the pulmonary artery is greater than 25 mm Hg at rest and greater than 30 mm Hg during exercise. This abnormally high pressure (pulmonary hypertension) is linked with changes in the small blood vessels in the lungs. These changes increase resistance to blood flowing through the vessels. This increased resistance puts a strain on the right ventricle, which now must work harder than usual to move enough blood through the lungs.
What are the causes?
The exact cause of PPH is not known but there may be one or more causes. There is a low incidence of PPH, which makes learning more about the disease extremely difficult. It is thought that in most people who develop primary pulmonary hypertension, the blood vessels are very sensitive to certain factors that trigger this disease to develop.

What are the symptoms?

The first symptom is often fatigue or tiredness.  Other symptoms include:

·                              -   Difficulty in breathing, dizziness and even fainting 

·                              -  Swelling in the ankles or legs,

·                                 Bluish discoloration of the lips and skin, and chest pain more often occur later in the disease

One of the great difficulties in treating PPH is that the diagnosis is often delayed due to the slowly progressive and insidious onset of the symptoms.
How is it diagnosed?
Significant advances in PPH treatment over the past decade have markedly affected the survival and quality of life for people with this disease. The optimal medical and/or surgical treatment for patients with PPH depends upon a thorough diagnosis and evaluation. The diagnosis includes a right heart cardiac catheterisation. In this procedure the doctor places a thin, flexible tube (a catheter) through an artery or vein in the patient's arm, leg or neck, then threads it into the right ventricle and pulmonary artery. This is the only way to measure the pressure in the pulmonary artery and find out what medical therapy is appropriate for a given patient.
What is the treatment?
Doctors can choose from a variety of drugs that help lower blood pressure in the lungs and improve heart performance in many patients. Patients with PPH respond differently to the different medications that dilate or relax blood vessels and no single drug is consistently effective in all patients. During the course of the disease, the amount and type of medicine also may have to be changed. At present, about one-quarter of patients can be treated with calcium channel-blocking drugs given orally.
Intravenous prostacyclin is a vasodilator. It helps patients who don't respond to treatment with calcium channel blockers given orally. It is continuously delivered by a portable, battery-operated infusion pump. Despite this complexity, prostacyclin improves pulmonary hypertension and permits increased physical activity.
Anticoagulants, for example, can decrease the tendency of the blood to clot, thus permitting the blood to flow more freely. Diuretics reduce the amount of fluid in the body, further reducing the amount of work the heart has to do. Some patients also require supplemental oxygen delivered through nasal prongs or a mask if breathing becomes difficult. Some patients need oxygen around the clock.
Transplantation (heart-lung or lung) is reserved for patients who do not respond to medical therapy. The decision whether a patient requires heart-lung transplantation or lung transplantation is made after a thorough evaluation.
What is the prognosis?
Despite the complexity of some of the various medical therapies, accurate, early diagnosis and initiation of treatment can save the lives of patients with PPH. With optimal medical and/or surgical therapy, patients can often return to a virtually normal lifestyle, and participating in many physical activities.

Diseases Caused by Alcohol Abuse

Most people associate alcohol abuse with two diseases. The first is alcoholism, which is a syndrome of dependency that some believe is inherited. The other would be cirrhosis, a disease that can be brought on by excessive alcohol consumption. But there are a number of other diseases and conditions that can develop, including pancreatic, hypertension, osteoporosis and Wernicke-Korsakoff syndrome.

Cirrhosis

• Cirrhosis is essentially a scarring of the liver. Healthy tissue of the liver is replaced with fibrosis, or scar tissue. As this scar tissue builds up, it prevents the liver from functioning properly, which can lead to bile build-up in the blood. Clotting may lessen and blood pressure may rise. Some of the most common symptoms of cirrhosis include lack of appetite, accompanied by weight loss, nausea, fatigue, jaundice, cognitive impairment (confusion and lack of concentration), tremors, internal bleeding and coma.

Pancreatitis

• Another common disease associated with alcohol abuse is pancreatitis, characterized by an inflammation of the pancreas and, much like cirrhosis, ultimate scarring of the organ. This scarring affects the production of insulin and the way in which sugar is released into the bloodstream. It often presents itself with severe abdominal pain that is typically accompanied by vomiting or nausea, the sweats and a fever.

Hypertension

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  While more of a condition than a disease, hypertension, or high blood pressure, is another result of alcohol abuse. This condition is distinguished by essentially too much blood being forced through the arteries, which can damage the walls of these arteries and lead to a stroke, heart disease, heart attack, angina, pulmonary edema and an aneurysm. Though high blood pressure is often seen as a hereditary condition, it can present itself in someone without a family history and even worsen hypertension in someone predisposed to it through genetics.

Osteoporosis

• One of the most surprising diseases caused by alcohol abuse is osteoporosis, which involves the thinning of the bones or loss of bone mass. This depletion makes bones more brittle. While it is most common in women, it can affect men, and excessive use of alcohol can diminish the vitamins and minerals needed for healthy bones, as well as but exacerbate the effects of someone developing osteoporosis.

Wernicke-Korsakoff Syndrome

• This brain disorder is a serious condition that can be caused by alcohol abuse. Essentially, this condition is a combination of two disorders that develop from a vitamin deficiency and an actual change in the brain. Typically, people who suffer from Wernicke-Korsakoff syndrome will experience blurred vision, memory loss, confusion and problems with mobility, usually isolated to the legs. Sadly, a portion of this syndrome (that which involves the brain) can be permanent.

  ***Reference eHow