Pulmonary hypertension is the high blood pressure on pulmonary arteries because of narrower arterial space. This disease is rare in infants and children, which may cause immature death of the affected people. In most of the cases, pediatric pulmonary hypertension is idiopathic (unknown cause) or genetic defect or immune system due to congenital heart disease. The explanation of pediatric pulmonary hypertension is similar to idiopathic pulmonary arterial hypertension in adults, in which pulmonary arterial pressure rises higher without any associated reasons. Sometimes it becomes very critical to diagnose the etiology of this disease and therefore proper treatments are not given to the infected child.
What happens in pulmonary hypertension?
At first you have to know how heart and lung works in blood purification. Blood from the whole body enter into the heart through the right atrium, then it goes to the right ventricle. Deoxygenated blood, then goes to the pulmonary through the pulmonary arteries for purification. In the lungs, deoxygenated blood converted into oxygenated blood and return back to the left atrium of the heart. Finally oxygenated blood spreads to the whole body through the left ventricle. In this system, pulmonary arteries have significant role and if it becomes narrower, a high pressure of blood exerts on the right heart and on the arterial walls, commonly known as pulmonary hypertension.
Classification of Pediatric Pulmonary Hypertension
In infants pulmonary hypertension is classified into two major groups, depending on their causes.
- Idiopathic pulmonary hypertension (IPH): when the causing agent of the disorder is unknown or unclear, we termed it as IPH. This type is also known as primary pulmonary hypertension. Genetic causes also belongs to this group. Some genes are responsible for pulmonary hypertension in children, while their parents have those defective genes as suppressed or activated.
- Secondary pulmonary hypertension: this type of defects arises due to other diseases, like-
a. Congenital heart disease, when baby born with a defective heart.
b. Liver and kidney disease.
c. HIV infection
d. Lung disorder
e. Chronic thrombolytic disease, where blood clots make blockage of the pulmonary arteries.
f. Environmental factors, drugs and toxins.
Causes of Pediatric Pulmonary Hypertension
The causes of pulmonary hypertension can be explained clearly in adults, but is complicated for infants. Generally, it occurs when heart faces extra load and becomes weaker to pump in a regular motion. Infant’s pulmonary arteries have smaller inner space and the space becomes narrower due to pulmonary disorders or thickening of the arterial lining or blocked by blood clots. These factors induce hypertension on pulmonary artery. Sometimes heart disease, liver disease, sleep apnea and connective tissue disorders also can be the reasons.
Symptoms of Pediatric Pulmonary Hypertension
At the initial stage, the symptoms are so minor that cannot be detected by general people. Symptoms are developed in an advanced stage when the disease has reached in worse condition. Parents should be concerned and the following symptoms may help you to find any abnormalities.
- Irregular and rapid heartbeat
- Shortness of breath or difficulty in breathing during physical exercise.
- Low blood pressure throughout the whole body
- Fainting spells
- Swelling of hands, legs and abdomen (edema)
Diagnosis of Pediatric Pulmonary Hypertension
Diagnosis of any disease is very important, especially for children, because they cannot explain their physical uneasiness. Diagnosis process of pediatric pulmonary hypertension is the same as adult pulmonary hypertension.
Treatments for Pediatric Pulmonary Hypertension
The curing treatment has not developed yet, but some treatments can improve the current conditions of your child. For idiopathic pulmonary hypertension, the goal of the treatments to control the worse effect. Normally medications are used, in critical condition, doctors go through surgical treatments. Some common medications are-
- Inhaled oxygen: patients become weaker because of oxygen deficiency in the blood. If extra oxygen is inhaled your child will be helped from fatigue, dizziness, fainting spells and others.
- Inhaled nitric oxide (NO): it will dilate blood vessel and blood pressure decreases. However, NO is given as short term therapy for hospitalized patients.
- Anticoagulants injection: it will help to remove the blockage of arteries made by blood clots, if any present. Anticoagulants also keep the blood thinner.
- Diuretics: it works by decreasing blood volume by excrete body water through urination. Low blood volume exerts low pressure on pulmonary arteries.
Some common surgeries for pulmonary hypertension are:
- Atrial septostomy: this surgery helps to pass out some blood from the right ventricle to the left ventricle. Therefore, blood pressure reduced in the right ventricle.
- Trans-vascular Potts procedure: a small by-pass is made between the aorta and the pulmonary artery, reducing arterial pressure.
- Lung transplantation: it is done when patients do not respond to other medications.