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The most important step in treating pulmonary hypertension is diagnosing the condition in its early stages. Once tests are done to determine the presence of the disease, and further tests are completed to determine the cause for the condition, the proper treatment can be assessed.
According to the American Heart Association, the most accurate test to determine pulmonary hypertension is a right heart cardiac catheterization. During this procedure, the doctor inserts a thin, flexible tube (catheter) through an artery or vein in the patient''s arm, leg or neck and threads it through to the right ventricle of the heart and the pulmonary artery. This allows the doctor to determine the pressure in the pulmonary artery and determine the most appropriate form of therapy for the individual patient.
Treatments for pulmonary hypertension vary depending on the patient, the cause and the progression of the disease. There is a variety of drugs that can be prescribed to treat symptoms, lower blood pressure and improve quality of life for the patient. Because each person responds differently to medications, doctors must thoroughly evaluate the patient to determine which medication would be best for that individual. The purpose of the drugs is to dilate and relax the blood vessels in the patient. The right heart cardiac catheterization can determine which medication will do that.
The American Heart Association reports that one-quarter of all people with pulmonary hypertension respond well to calcium channel-blocking oral medications. In patients who don''t respond to this medication taken orally, doctors prescribe chronic intravenous prostacyclin. This is continuously delivered by a portable, battery-operated infusion pump. This treatment is usually used in the later stages of the disease on people awaiting a heart or lung transplant.
Other methods of treatment are being researched and developed for people that don''t respond to either calcium channel blockers or intravenous prostacyclin. Medications that improve function in the right ventricle have also been found to help people with pulmonary hypertension. These include anticoagulants, which decrease the tendency of blood clots and permit the blood to flow more quickly through the body, and diuretics, which reduce the amount of fluid in the body and reduce the amount of work the heart is required to do. Supplemental oxygen is often needed to assist breathing in people with advanced pulmonary hypertension. Transplantation, either heart-lung or lung, is reserved for people who don''t respond to any other form of treatment.
No matter what treatment is chosen, the amount or method may be altered or increased at any time during the course of treatment. The disease should be consistently monitored by a physician to determine what steps to follow.
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