Unexplained Fatigue

Could it be Pulmonary Arterial Hypertension? 

High blood pressure, or hypertension, affects nearly 50 million Americans. However, there is another, less common type of hypertension that affects the arteries of the lungs instead of your heart. It’s called pulmonary arterial hypertension (PAH) and in most cases unexplained shortness of breath with minimal activity is a telltale sign. Pulmonary arterial hypertension begins when the lungs’ tiny arteries either narrow or become blocked. This causes increased resistance of blood flow in the lungs, which in turn raises pressure within the pulmonary arteries. As the pressure builds, the heart’s right ventricle must work harder to pump blood through the lungs, eventually causing the heart muscle to weaken and sometimes fail completely. This is called right heart failure. The most common signs of pulmonary arterial hypertension are shortness of breath with activity, fatigue, dizziness, chest pain and, in the late stages of PAH, fainting. Symptoms usually limit a person’s ability to exercise and do other activities of daily living. 

Frequently Misdiagnosed 

Pulmonary hypertension is frequently misdiagnosed, therefore, it is often late-stage by the time it is accurately diagnosed. The average life expectancy of a patient with PAH is three to five years, yet new treatments have enabled some patients to manage the disorder for 15 to 20 years or longer.

Common causes of PAH are familial and can also include birth defects in the heart, sleep apnea, connective tissue disorders (lupus, scleroderma, rheumatoid arthritis), congestive heart failure, chronic pulmonary thromboembolism (old blood clots in the pulmonary arteries) and human immunodeficiency virus (HIV) infection. When the cause of PAH is known, it is called secondary PAH; however, sometimes the cause is not known and this is called primary PAH.

Signs of PAH can be similar to the signs of many other health problems, therefore, to find out if you have it, your doctor may do an echocardiogram. For this test, an instrument called a probe is placed on the outside of the chest. The probe sends out sound waves that are used to form pictures of your heart and estimate the blood pressure in your pulmonary arteries.

If the cause of your pulmonary hypertension is known, treating the cause may help. Breathing oxygen from a tank is one treatment option. There are also other types of medicines that may be used to treat PAH. Drug therapies for PAH include oral, inhaled or IV medications.

In the past few years, doctors have continued to research PAH and learned how to better treat patients with the condition. Researchers continue to make great strides in finding new treatments that may prolong lives, as well as improve quality of life.

For more information about PAH or to schedule an appointment, contact the John Ochsner Heart and Vascular Institute Pulmonary Hypertension Department at 504-842-6090.