DISEASES OF THE VEINS: DISEASES OF THE PULMONARY ARTERIES – PUMONARY HYPERTENSION

Atherosclerosis can present in pulmonary arteries, but seldom if ever produces symptoms other problems. Also, the pulmonary arteries are the “target” of emboli that may form in the deep veins of the leg and they may also be involved in inflammatory conditions (see page 104 The pulmonary arteries, however, are subject to some problems that are different from those affecting the arteries that serve the rest of the body or from problems with the veins.Pulmonary Hypertension. The condition that most commonly affects the pulmonary circulation is pulmonary hypertension. This general term refer to conditions that raise the blood pres sure in the arteries to the lungs but no in other arteries.Causes of Pulmonary Hypertension. In most cases of pulmonary embolism ir which the initial event is survived, there are no subsequent problems with the pulmonary arteries. However, in rare cases the embolus does not dissolve and instead remains as an obstruction to blood flow through the lungs. The final result may be pulmonary hypertension.Congenital heart conditions in which there is excessive blood flow through the pulmonary blood vessels may also lead to a condition of severe pulmonary hypertension known as Eisenmenger’s complex (see page 55).Any situation that continuously lowers the amount of oxygen getting into the bloodstream, whether it is due to constant living at a very high altitude or to emphysema, may elevate pulmonary blood pressure.Finally, pulmonary hypertension can exist in the absence of any apparent cause. This is called primary pulmonary hypertension, to indicate that it is the main problem rather than secondary to another problem.Symptoms of Pulmonary Hypertension. The earliest symptoms are usually tiredness and shortness of breath that become progressively worse with time. Other symptoms include angina (chest pain), passing out spells (syncope), and blueness of the skin (cyanosis). In the later stages of the disease, the right ventricle can no longer pump blood effectively, and symptoms of right ventricular failure develop: swelling of the legs, enlargement and pain in the abdomen, loss of appetite, and bulging of the jugular veins in the neck.*213\252\8*

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