Congestive heart failure is also called heart failure and is the pathophysiological state in which an abnormal cardiac function is responsible for decreased efficiency in the ability of the heart to pump blood. This decreased efficiency and effectiveness leads to a decreased oxygen supply to tissues around the body and subsequent symptoms which can result in death. In order to understand the relationship between pulmonary hypertension and congestive heart failure it is essential that you have a basic understanding of how the heart works. (1)
The heart consists of four separate chambers. The top two chambers are called atria in the bottom two chambers are called ventricles. Blood enters the heart through the right atrium, passes through to the right ventricle where it is pumped out to the lungs through the pulmonary artery. Here the blood picks up oxygen and is carried back to the heart in through the left atrium through the pulmonary vein. The blood then travels into the left ventricle where the heart pumps it out through the aorta to the rest of the body.
Pulmonary hypertension is a diagnosis that describes high blood pressure in the pulmonary artery, or the blood vessel that leads from the heart into the lungs. The pressure in the pulmonary artery is usually lower compared to that pressure which is in the aorta. Having a higher blood pressure in the pulmonary artery can create irrevocable damage to the lungs and cause the right ventricle to fail as it pumps against a greater pressure than it was designed to pump against.
Pulmonary hypertension can both cause congestive heart failure or be caused by congestive heart failure. Pulmonary hypertension is usually divided into a primary type and secondary type. Primary pulmonary hypertension has an origin of unknown etiology. In other words, it happens with no family history, no familial form and no primary disease. Secondary pulmonary hypertension can be due from congenital heart disease, pulmonary embolism, collagen and vascular disorders, sarcoidosis, HIV or portal hypertension. Pulmonary hypertension can also be a result of blood clots, lung disease, heart disease and sleep disorders. (2)
Pulmonary hypertension is suspected when an x-ray or echocardiogram indicates an enlargement of the right ventricle. A cardiac catheterization will allow a physician to diagnose pulmonary hypertension and determine the best treatment plan for your individual needs. CAT scans, pulmonary function tests, exercise tests, perfusion lung scans, magnetic resonance imaging and blood tests will all be used to track the progress of the disease in its response to treatment.
Left untreated pulmonary hypertension will result in heart failure, blood clots and fluid buildup in the lungs and legs. Treatment options will include a variety of oral and inhaled medications which include diuretics to help rid the body of extra fluid which puts extra pressure on the heart, anticoagulants that reduces the risk of blood clots, calcium channel blockers, and a variety of other medications which can be delivered either orally or through an intravenous method in order to relieve shortness of breath and help ease the symptoms of pulmonary hypertension.
In the United States more than 3 million people have congestive heart failure. Individuals who suffer from congestive heart failure and pulmonary hypertension should avoid pregnancy, high altitude, decongestants, beta-blockers and nonsteroidal anti-inflammatory is because they place a large workload on the heart and lungs.
When patients with heart failure become unresponsive to combination of treatment protocols and physicians believe they are unlikely to survive one year they can be considered for a heart-lung transplantation. They are not qualified candidates for heart transplants because of the pulmonary hypertension but may qualify for a heart lung transplants if there are underlying medical conditions do not rule them out.
(1) American Heart Association: What is Heart Failure
(2) US National Library of Medicine: Pulmonary Hypertension
RESOURCES
University of Maryland Medical Center: Heart Failure
Cleveland Clinic: Pulmonary Hypertension
National Heart Lung and Blood Institute: What is Pulmonary Hypertension
Circulation: Secondary Pulmonary Hypertension in Chronic Heart Failure
American Heart Journal: Reversibility of pulmonary hypertension in congestive heart failure patients evaluated for cardiac transplantation: comparative effects of various pharmacologic agents