Increase in blood pressure in the arteries of the lungs. It is called hypertension if the reading is more than 25 mmHg at rest or more than 30 mmHg during exercise. The increased pressure overloads the heart, which has to work harder to pump blood back into the lungs.
The most common causes are: hereditary, heart disease, lung disease and pulmonary circulation involvement due to emboli or thrombi.
The main symptom is a feeling of breathlessness, first during exercise and later at rest. Other symptoms include night sweats, chronic cough, chest pain and headaches.
Suspected diagnosis is clinical, based on history and physical examination. Additional tests are needed to confirm the diagnosis, most commonly an electrocardiogram, chest x-ray and echocardiography.
Treatment must be individualised to normalise blood pressure, improve cardiac output and oxygenation. It is based on vasodilator drugs and supporting drugs (diuretics, anticoagulants, oxygen therapy, digoxin, etc.).
- Ann R Stark, MD. Eric C Eichenwald, MD. Persistent pulmonary hypertension of the newborn. UpToDate. Apr 19, 2016.
- Abman SH, Hansmann G, Archer SL, et al. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society. Circulation 2015; 132:2037.
- Cole FS, Alleyne C, Barks JD, et al. NIH Consensus Development Conference statement: inhaled nitric-oxide therapy for premature infants. Pediatrics 2011; 127:363.
- Rosenberg AA, Lee NR, Vaver KN, et al. School-age outcomes of newborns treated for persistent pulmonary hypertension. J Perinatol 2010; 30:127.
