As a consequence of delayed detection of birth defects of the heart patients can develop permanent damage and high pressure in the lungs (pulmonary hypertension). This can lead to them becoming unsuitable for surgery. This is one of the main reasons for emphasizing the importance of early detection and treatment of birth defects of the heart (preferably during pregnancy or soon after birth).
In this post I will aim to outline the treatment options available to treat patients with pulmonary hypertension who are often not suitable for surgery or keyhole treatment.The reason I want to particularly highlight this group of patients is that their care is often found wanting and in some parts of the world they are simply sent away saying 'Nothing can be done'. Although a complete cure may not be possible for these patients they do require regular follow up, medication and lifestyle advice on issues like pregnancy, contraception, exercise etc.
Until recently good medical therapy for this group of patients was not available and they were condemned to a life of gradual deterioration and early demise. Now, there are a wide range of medications that are available that can improve the quality of life of these patients and prolong their survival. The medications do come at a cost (between 750 and 5000 INR per month depending on the medication that is used) but they have been shown to improve the exercise capacity and quality of life of these patients and are indirectly believed to improve their long term survival as well. Prior to starting medical therapy patients may require a cardiac catheter test to establish clearly that there is no scope for curative treatment.
Apart from medications these patients need counselling regarding various issues in life. Pregnancy in women with severe pulmonary hypertension should be strongly discouraged as it can lead to the death. This should be clearly explained to the patient and their family. Good advice regarding safe and reliable contraception should be given. Mild exercise like walking and swimming can be carried out but patients should be advised not to push themselves or participate in a competitive fashion. Activities like weight lifting should not be allowed.
Above all this, patients with pulmonary hypertension are often adolescents and young adults who suddenly find themselves different from their friends and peers. They have to deal with the emotional trauma of living with a condition that does not have a definite cure. The doctor's consultation should allow them to express their doubts and apprehensions and help them face life with positivity and courage.
In this post I will aim to outline the treatment options available to treat patients with pulmonary hypertension who are often not suitable for surgery or keyhole treatment.The reason I want to particularly highlight this group of patients is that their care is often found wanting and in some parts of the world they are simply sent away saying 'Nothing can be done'. Although a complete cure may not be possible for these patients they do require regular follow up, medication and lifestyle advice on issues like pregnancy, contraception, exercise etc.
Until recently good medical therapy for this group of patients was not available and they were condemned to a life of gradual deterioration and early demise. Now, there are a wide range of medications that are available that can improve the quality of life of these patients and prolong their survival. The medications do come at a cost (between 750 and 5000 INR per month depending on the medication that is used) but they have been shown to improve the exercise capacity and quality of life of these patients and are indirectly believed to improve their long term survival as well. Prior to starting medical therapy patients may require a cardiac catheter test to establish clearly that there is no scope for curative treatment.
Apart from medications these patients need counselling regarding various issues in life. Pregnancy in women with severe pulmonary hypertension should be strongly discouraged as it can lead to the death. This should be clearly explained to the patient and their family. Good advice regarding safe and reliable contraception should be given. Mild exercise like walking and swimming can be carried out but patients should be advised not to push themselves or participate in a competitive fashion. Activities like weight lifting should not be allowed.
Above all this, patients with pulmonary hypertension are often adolescents and young adults who suddenly find themselves different from their friends and peers. They have to deal with the emotional trauma of living with a condition that does not have a definite cure. The doctor's consultation should allow them to express their doubts and apprehensions and help them face life with positivity and courage.
