Pulmonary Vascular Disease: Symptoms, causes, diagnosis and treatment

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Pulmonary Vascular Disease
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Pulmonary Vascular Disease

• 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.

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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.

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Symptoms

• 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. 
• 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.

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How is pulmonary vascular disease diagnosed?

• 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.

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Treatments

• 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. 

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Treatments
Continue

• 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.

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