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Pulmonary Arterial Hypertension

AMBULATORY CARE:

Pulmonary arterial hypertension (PAH)

is a condition that increases pressure in your pulmonary artery. The pulmonary artery is the large blood vessel that brings blood from your heart to your lungs.

Common signs and symptoms include the following:

  • Feeling weak and tired
  • Weight gain or lack of appetite
  • Joint pain
  • Shortness of breath with exercise
  • Abdominal swelling
  • Chest pain or heart palpitations (strong, fast heartbeats)
  • Dizziness or feeling faint

Call 911 for any of the following:

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

Seek care immediately 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.

Treatment for PAH

may include any of the following:

  • Medicine may be given to improve blood flow, get rid of extra fluid, or prevent blood clots. Blood clot medicine may make you bruise or bleed more easily. Use a soft toothbrush and an electric shaver to prevent bleeding.
  • You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.
  • Surgery may be used to help blood flow from one part of the heart to another. You may need lung or heart transplant surgery if other treatments do not work and your condition is severe.

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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