Re: pulmonary hypertension

Posted By Cheryl on April 27, 1999 at 21:08:07
Hello again.  I have posted before and you've always been very helpful.  I have another "preschool" question.  I recently did an intake for a three year old who has pulmonary hypertension.  He was placed on a heart-lung bypass machine shortly after birth which apparently is what caused the pulmonary hypertension.  This child currently takes lanoxin and lasix.  The mother says he has no restrictions and there is nothing I should be concerned about.  This mother seems very young and not real knowledgable about this.  Given the seriousness of some of the health problems I have dealt with lately, I just want to make sure I know everything about a child with this condition.  Is this a serious problem with children?  What do I need to be concerned about?  My preschool is designed for children with special needs so health problems will not exclude him from preschool.  I just want to make sure we are prepared.  Thanks for your information!

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD -CRC on April 29, 1999 at 16:52:51

Dear  Cheryl,
Thank you for your question.  Pulmonary artery (PA) pressure is much like systemic blood pressure except that it is the blood pressure in the lungs.  PA pressure is  a low pressure system with the normal pressure being about 25/12 mmHg with a mean pressure of 16 mmHg.  
There are many causes of high pulmonary pressures.  The most likely cause is long standing heart valve problems. Other potential causes are chronic blood clots (pulmonary thrombosis),  congenital heart disease, obstructive lung disease, collagen vascular disease, parasitic disease involving the lung, sickle cell anemia, IV drug abuse and chronic liver disease.  If no cause of the hypertension can be found the diagnosis of primary pulmonary hypertension is made.  
The treatment of pulmonary hypertension can be difficult.  Vasodilator drugs such as calcium channel blockers can be used.  Nitric oxide lowers PA pressure but only lasts for a very short time.  Flolan (Prostacyclin) lasts for a longer time but must be given intravenously and is very expensive.   Anticoagulation is recommended for patients with blood clots.   For patients who fail to respond to medical therapy the only option is lung transplantion.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.











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