Pulmonary Vascular Disease

Related to bood vessels leading to or from the lungs.

It is also defined as any condition that affects the blood vessels along the route between the heart and lungs.

Pulmonary vascular disease can be divided into pulmonary arterial hypertension, pulmonary embolism and pulmonary venous hypertension.

Signs or symptoms:

The symptoms of pulmonary vascular disease vary according to several factors:

  • The suddenness of the process affecting the pulmonary blood vessels
  • Which pulmonary blood vessels are affected (where the pulmonary vascular disease is)
  • How much of the pulmonary vascular system is affected

Pulmonary arterial hypertension: Slowly progressive shortness of breath. As the condition worsens, chest pain or fainting (syncope) with exertion can occur. Breathless feeling, dizziness, fainting, chest pain or palpitations and extreme fatigue. Pulmonary Arteries constrict.

Pulmonary embolism: A blood clot to the lungs occurs suddenly. Shortness of breath, chest pain (often worse with deep breaths), and a rapid heart rate are common symptoms. Pulmonary embolism symptoms depends on the size of the blood clot(s).

Pulmonary venous hypertension: Shortness of breath, due to the congestive heart failure. Shortness of breath may be worse while lying flat, when blood pressure is uncontrolled, or when extra fluid is present (edema).

Causes:

Pulmonary arterial hypertension: Increased blood pressure in the pulmonary arteries (carrying blood away from the heart to the lungs)

Pulmonary Venous Hypertension: Increased blood pressure in the pulmonary veins (carrying blood away from the lungs, to the heart).

Pulmonary Embolism: A blood clot breaks off from a deep vein (usually in the leg), travels into the right heart, and is pumped into the lungs.

Risk factors

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Smoking
  • Family history

Diagnosis for Pulmonary Vascular Disease

Based on a person’s symptoms, signs, and history, a doctor may begin to suspect the presence of pulmonary vascular disease. The diagnosis of pulmonary vascular disease is usually made using one or more of the following tests:

  • Computed tomography (CT scan): A CT scanner takes multiple X-rays, and a computer constructs detailed images of the lungs and chest. CT scanning can usually detect a pulmonary embolism in a pulmonary artery. CT scans can also uncover problems affecting the lungs themselves.
  • Ventilation/perfusion scan (V/Q scan): This nuclear medicine test takes images of how well the lungs fill with air. Those images are compared to pictures of how well blood flows through the pulmonary blood vessels. Unmatched areas may suggest a pulmonary embolism (blood clot) is present.
  • Echocardiography (echocardiogram): An ultrasound video of the beating heart. Congestive heart failure, heart valve disease, and other conditions contributing to pulmonary vascular disease can be discovered with echocardiogram.
  • Right heart catheterization: A pressure sensor is inserted through a needle into a vein in the neck or groin. A doctor advances the sensor through the veins, into the right heart, then into the pulmonary artery. Right heart catheterization is the best test to diagnose pulmonary arterial hypertension.
  • Chest X-ray film: A simple chest X-ray can’t diagnose pulmonary vascular disease. However, it may identify contributing lung disease, or show enlarged pulmonary arteries that suggest pulmonary arterial hypertension.
  • Pulmonary angiography (angiogram): Contrast dye is injected into the blood, and X-ray images of the chest show detailed images of the pulmonary arterial system. Angiography is very good at diagnosing pulmonary embolism but is rarely performed anymore because CT scans are easier, less invasive, and have lower risk

Medical concept, not for try:

Pulmonary arterial hypertension: Lower blood pressure in the pulmonary arteries:

  • removed, consult medical professional.

Pulmonary venous hypertension: Because this form of pulmonary vascular disease is usually caused by congestive heart failure,  the treatments for heart failure are similiar:

  • removed, consult medical professional

Pulmonary embolism: reduce blood clotting.

  • removed, consult medical professional

For medical students reference only. As patient, never change drug prescription.

  • Picture on right are few X-Ray