PULMONARY HYPERTENSION (PH)

Pathophysiology Clinical Manifestation

 The rare and life-threatening disease pulmonary
hypertension (PH) is characterized by high blood
pressure in the lungs and occurs when the
pulmonary arteries become clogged and
narrowed. The pulmonary arteries are the vessels
responsible for the transport of blood from the
heart to the lungs.
 engorgement, crackles, and heart murmur).
 Dyspnea, the main symptom of PH, occurs at
first with exertion and eventually at rest.
Substernal chest pain also is common. Other
signs and symptoms include weakness, fatigue,
syncope, occasional hemoptysis, and signs of
right-sided heart failure (peripheral edema,
ascites, distended neck veins, liver
Anorexia and abdominal pain in the right upper
quadrant may also occur.

Medical Management
 The primary goal of treatment is to manage the
underlying condition related to PH if the cause is
known.
 Diuretics and oxygen should be added as needed.
 Most patients with PH do not have hypoxemia at rest
but require supplemental oxygen with exercise. Nursing Management
 Anticoagulation should be considered for patients at
 The major nursing goal is to identify
risk for intrapulmonary thrombosis.
patients at high-risk for PH, such as those
 Digoxin may improve right ventricular ejection
with COPD, PE, congenital heart disease,
fraction in some patients and may help to control
and mitral valve disease so that early
heart rate; however, patients must be monitored
treatment can commence.
closely for potential complications (Rubin & Hopkins,
 The nurse must be alert for signs and
2016).
symptoms, administer oxygen therapy
appropriately, and instruct the patient and
family about the use of home oxygen
Surgical Management therapy
 Lung transplantation remains an option for a  Emotional and psychosocial aspects of this
disease must be addressed. Formal and
select group of patients with PH who are
informal support groups for patients and
refractory to medical therapy.
families are extremely valuable.
 Bilateral lung or heart-lung transplantation is the
procedure of choice. Atrial septostomy may be
considered for selected patients with severe
disease (Hopkins & Rubin, 2016)