Effective treatment options to manage pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a condition that is characterized by high blood pressure in the lungs. PAH occurs in small arteries as it obstructs blood flow in the lungs, causing a series of symptoms like COPD (Chronic Obstructive Pulmonary Disease) and asthma. The rarity of this disease can be gauged from the fact that only one to two out of a million people in the country suffer from PAH. It has been observed that this condition usually affects both the genders equally between the ages of 30 and 60. Here are some PAH treatments that can help better manage the disease.

Non-invasive PAH treatments (Medications)

• Vasodilation
  Blood vessel dilation can relax and widen narrowed blood vessels to improve blood flow. Vasodilators are administered intravenously through an IV line attached to a pump. Patients who cannot use vasodilators using a pump can use different types of vasodilators that can be injected, inhaled, or even taken orally. Nebulizers are also used for administering vasodilators. Nebulizers vaporize medications that can be inhaled by the patients. It is important to be aware of the side effects so that they can be managed accordingly. Some side effects include jaw pain, nausea, leg cramps, diarrhea, pain, and rash at the IV site.
• Endothelin receptor reversing medicines
  Endothelin is a substance present in the blood vessels that helps in narrowing them. Endothelin receptor reversing medicines can stop the blood vessels from narrowing. Although these medicines improve energy levels and PAH symptoms, they can potentially damage the liver and its functions. So, these medications should be avoided if you’re pregnant.
• GSC stimulators
  Another non-invasive PAH treatment, GSC or Guanylate cyclase stimulators, relaxes pulmonary arteries by increasing nitric oxide level in the body. This can lower the pressure within the arteries and help improve PAH symptoms. Side effects of these stimulators include dizziness, nausea, and fainting. These medications should not be taken during pregnancy.
• Anticoagulants (blood thinners)
  Some medications can be used as blood thinners, preventing the formation of blood clots in the lung’s arteries. However, these medications need to be taken under a doctor’s prescription as anticoagulants can delay the blood clotting process. This can put the patient at risk of bleeding. It can be dangerous during surgeries, as it might become difficult to control the blood flow.
• Diuretics
  These are one of the most commonly used medicines for kidney diseases. Diuretics help kidneys remove excess fluid from the body. This helps in reducing the fluid buildup in the lungs, which reduces the pressure in the small arteries. Diuretics might be used in conjunction with other medications that help relax the blood vessels, ease the blood flow in the lungs, and improve PAH symptoms further.
• Oxygen therapy
  This type of PAH treatment is often advised for people who exhibit moderate to severe symptoms. This therapy involves breathing pure oxygen to relieve the blood pressure in the lungs. Oxygen can be supplied through tubes, face masks, or tubes placed inside the trachea (windpipe). The therapy is also used by people who live at higher altitudes or suffer from sleep apnea.

Invasive PAH treatments

• Pulmonary angioplasty
  This is an invasive PAH treatment that involves guiding a tiny balloon into the arteries and inflating it for a few seconds. This reduces the blockage, thereby restoring the blood flow. This form of treatment improves breathing and reduces PAH symptoms by lowering blood pressure.
• Pulmonary endarterectomy
  It is specifically used for treating chronic symptoms of pulmonary hypertension. This surgical procedure involves removing old blood clots in the pulmonary arteries in the lungs. For patients who cannot undergo pulmonary endarterectomy, pulmonary angioplasty is recommended.
• Atrial septostomy
  It is an invasive PAH treatment that involves piercing a small hole using a cardiac catheter between the right and left atria. The thin, flexible tube is inserted into the blood vessels or heart chambers to reduce the pressure on one side (preferably) of the heart. This allows the heart to pump blood efficiently, reducing the blood pressure in the lungs.
• Transplant
  If none of the medications or surgical interventions are effective, doctors might recommend lung transplant. However, this PAH treatment is only suitable for younger patients. A lung transplant can be risky as it may induce severe infection and rejection by other organs.