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Pulmonary Arterial Hypertension

WHAT YOU NEED TO KNOW:

Pulmonary arterial hypertension (PAH) is a condition that increases blood pressure in your pulmonary artery. The pulmonary artery is the large blood vessel that brings blood from your heart to your lungs.

DISCHARGE INSTRUCTIONS:

Call 911 for any of the following:

  • You have chest pain or heart palpitations (strong, fast heartbeats).
  • You have shortness of breath at rest, especially when you lie down.

Return to the emergency department if:

  • Your legs or ankles are swollen.
  • You are vomiting and cannot eat or drink.
  • You are confused or feel like you are going to faint.

Contact your healthcare provider if:

  • You have a fever.
  • Your symptoms keep you from doing your daily activities.
  • Your joints are painful and swollen.
  • Your fingers or toes are clubbed (the ends are round and thick).
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Diuretics help your body get rid of extra fluid and protect your heart from more damage. You may urinate more often while you are taking diuretics.
  • Vasodilators improve blood flow by making the vessels in your heart and lungs wider.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Manage PAH:

  • Check your blood pressure (BP) at home. Sit and rest for 5 minutes before you take your BP. Extend your arm and support it on a flat surface. Your arm should be at the same level as your heart. Follow the directions that came with your BP monitor. If possible, take at least 2 BP readings each time. Take your BP at least twice a day at the same times each day, such as morning and evening. Keep a record of your BP readings and bring it to your follow-up visits. Ask your healthcare provider what your BP should be.

  • Limit sodium (salt) as directed. Too much sodium can affect your fluid balance. Check labels to find low-sodium or no-salt-added foods. Some low-sodium foods use potassium salts for flavor. Too much potassium can also cause health problems. Your healthcare provider will tell you how much sodium and potassium are safe for you to have in a day. He or she may recommend that you limit sodium to 2,300 mg a day.

  • Follow the meal plan recommended by your healthcare provider. A dietitian or your provider can give you more information on low-sodium plans or the DASH (Dietary Approaches to Stop Hypertension) eating plan. The DASH plan is low in sodium, unhealthy fats, and total fat. It is high in potassium, calcium, and fiber.

  • Limit liquids as directed. You may need to drink less liquid to help balance your fluid level. Ask how much liquid you should drink each day. Your healthcare provider will give you an exact amount of liquid to drink each day. You may be limited to less than 2 liters a day.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can increase your BP and also cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Limit alcohol. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Exercise as directed. Exercise may help decrease your symptoms and improve your heart function. Exercise also helps with weight control. Do not start an exercise program before you talk with your healthcare provider.
  • Avoid activities that raise your body temperature. Do not sit in a sauna, hot tub, or hot bath. This can lower your blood pressure and cause you to faint.
  • If you are a woman, talk to your healthcare provider about pregnancy. Pregnancy may not be safe for you. You may need to change your birth control method if you currently use birth control pills. Birth control pills may increase your risk for blood clots. Your healthcare provider can help you choose other methods that work for you.
  • Manage health conditions affecting PAH. You many need treatment for sleep apnea, hypertension, or other medical conditions. Ask your healthcare provider for more information.
  • Do not travel to high altitudes unless your healthcare provider says it is okay. You may need to bring extra oxygen if you are traveling to a high altitude or are flying.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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