Pathology and Treatment of Pulmonary Arterial Hypertension

The pulmonary vasculature contains arteries and arterioles, which branch in the lungs to create a dense capillary bed to provide blood flow. The pulmonary capillary bed is a high-volume, low-pressure, low-resistance system that delivers blood to and from the lungs via the arterial and venous circulation systems. The right ventricle of the heart is responsible for pumping blood to the pulmonary artery and to the lungs so it can be oxygenated while the left ventricle pumps oxygenated blood to the tissues. Typically, hypertension refers to high blood pressure in the systemic circulation, however, an increase in blood pressure may also occur in pulmonary circulation. The pulmonary artery supplying blood to the lungs can become narrowed,†¦show more content†¦Increased levels of pro-inflammatory cytokines and chemokines result in an infiltration of inflammatory cells forming plexiform lesions consisting of T cells, B cells and macrophages (Savaj et al., 2012). Scleroderma, or syst emic sclerosis, is a connective tissue disease characterized by a thickening of the skin. Accumulation of collagen by fibroblasts, platelet adhesion and a type II hypersensitivity reaction lead to endothelial damage. Endothelial damage and decreased vasodilatation result in increased arterial pressure leading to PAH (Mclaughlin, 2009). Patients generally have a poor prognosis unless detected early, as a cure for slceroderma does not exist. Patients with advanced liver disease can also develop PAH. Portopulmonary hypertension (PPH) is a combination of high blood pressure in the portal and pulmonary systems. Unless transplantation can occur, prognosis for these patients is less than ideal. In order to be considered for transplantation, patients must have a mean arterial pressure less than or equal to 35 mm Hg. Long term cocaine and methamphetamine abuse have been linked to developing PAH (McLaughin et al., 2009). Cocaine can cause overexcitement of the sympathetic nervous system triggering an erratic, potentially severe condition called vasospasm, which involves a rapidShow MoreRelatedThe Heart Is A Hollow, Muscular Organ Of The Middle Mediastinum Orientated Obliquely961 Words   |  4 Pagesgrooves indicate these divisions: the atria are separated from the ventricles by the coronary sulcus (the atrioventricular groove) with a hiatus anteriorly at the root of the pulmonary artery (PA). The atria are separated posteriorly by the inter-atrial groove though this is scarcely marked, and anteriorly this is hidden by the pulmonary artery and aorta. 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