肺动脉高压和冠心病

这是什么??

High blood pressure in the arteries that supply the lungs is called pulmonary hypertension (PH) or pulmonary arterial hypertension (PAH). The blood pressure measured by a cuff on your arm isn't directly related to the pressure in your lungs. 供应肺部的血管收缩，血管壁增厚, 所以它们不能携带那么多的血液. 就像纠结的花园水管一样，压力不断积聚，又不断恢复. 心脏更加努力地工作，试图迫使血液通过. 如果压强足够高, 最终，心脏跟不上了, 通过肺部循环吸收氧气的血液也减少了. 然后患者会感到疲倦、头晕和呼吸急促.

PH -原因和修复

If a pre-existing disease triggered the PH, doctors call it secondary pulmonary hypertension. That's because it's secondary to another problem, such as a left heart or lung disorder. However, congenital heart disease can cause PH that's similar to PH when the cause isn't known, i.e.特发性或不明原因肺动脉高压. 在这种情况下, the PAH is considered pulmonary arterial hypertension associated with congenital heart disease, 例如与a相关联的 房间隔缺损 or 自闭症谱系障碍 (已修好或未修好). 问题是由于肺部小动脉的疤痕.

It's important to repair congenital heart problems (when possible) before permanent pulmonary hypertensive changes develop. 心内左向右分流(如室间隔缺损或房间隔缺损), a hole in the wall between the two ventricles or atria) can cause too much 血液流动 through the lungs. 这种情况有时被称为艾森曼格情结. 在过去, the holes can't be repaired due to increased stress on the heart produced by the high pressures in the scarred lung blood vessels. 随着新药的出现，这种情况正在发生变化. 心脏瓣膜状况，如 二尖瓣狭窄 (二尖瓣变窄)，也可引起继发性PH. 固定阀门通常会逆转PH值.

儿童肺动脉高压

有些患有先天性心脏病的儿童肺部有高血压. 这被称为肺动脉高压. Surgical repair of a heart defect will often lead to improvement and normal blood pressure in the lungs. In other cases the pressure may remain higher than normal, making it harder for the heart to pump. 在极少数情况下，压力可能会高到手术风险太大.

Oxygen or medications may be used to try to relax the blood vessels and reduce the blood pressure in the lungs after surgery. 如果不能进行手术，也可以使用这些治疗方法. 

先天性心脏病肺动脉高压所致的紫绀

当左右心之间有交流时(自闭症谱系障碍), 室间隔缺损和房室间隔缺损)或循环(掌上电脑), blood goes from the low oxygen chamber or vessel to the high oxygen chamber or vessel. An example would be shunting from the right atrium to the left atrium in patients with atrial septal defect (自闭症谱系障碍) and pulmonary arterial hypertension. 曾经无紫的病人变成了紫绀. One way the body compensates is to increase the ability of the blood to carry oxygen by increasing the number of red blood cells, 一种叫做继发性红细胞增多症的疾病, 有时称为红细胞增多症. It is now recognized that removing blood with a procedure called phlebotomy is only rarely needed. 可能促使医生建议服用的症状是头痛, 过度疲劳和运动耐受性恶化. Before this is performed, it is important that the doctors tests for iron deficiency. Phlebotomy is preferably performed in a center with experience in adult congenital disease as special precautions are required.

治疗肺动脉高压

Once pulmonary hypertension has been diagnosed, often more medical therapy is needed. You'll require regular follow-up with a cardiologist or pulmonologist trained in caring for patients with this condition.

只要潜在的疾病存在，它就会不断引起多环芳烃. 一旦你有多环芳烃(特别是如果你已经有一段沙巴足球体育平台了), 治疗引起高血压的疾病可能不会使高血压消失. 在这种情况下，多环芳烃通常需要特殊治疗. 虽然PH是一种严重的疾病，但治疗方法是可行的. 你可以用氧气治疗, 帮助心脏更好跳动的药剂, 利尿剂, anticoagulants (*blood thinners) and medications to lower your PAH and reverse the scarring in the blood vessels in the lung. 有时肺移植也用于治疗多环芳烃, 而是先天性心脏病, 通常需要心肺移植.

体育活动与肺动脉高压

A diagnosis of PAH doesn't necessarily mean you can't have an active, fulfilling life. 尽管如此，你还是应该考虑一些措施和预防措施. 多环芳烃是一种终身疾病，多种因素会使病情恶化, 比如吸烟或到高海拔地区旅行.

一旦诊断出多环芳烃，你必须寻求有关体育活动的建议. 如果你有多环芳烃，你应该尽可能多运动. Strenuous physical activity; however is associated with serious increases in pulmonary artery pressure. 因此, 避免等长运动和举重之类的活动, 或者卧推会产生危险的症状, 比如胸痛或头晕. 一个有监督的心肺康复计划可能有助于促进调节. 许多多环芳烃患者报告说，他们的日子“有好有坏”.“如果你需要休息，那就休息吧.

药物

Most medications often used to treat coexistent illnesses are safe for people with PAH. 尽管如此，在服用处方药和非处方药时还是要小心. Any anesthetics or sedatives can be very hazardous; ask your physician which medications are safe. 与你的医生讨论减充血感冒药的使用.

怀孕及避孕

有酸碱度的妇女不建议怀孕. The changes associated with pregnancy and delivery produce changes that can seriously endanger the life of the mother and baby. 因此 it is important for women with PH to use a more permanent but safe form of contraception. Because estrogen can aggravate PH, it's important to avoid any contraception containing estrogen. 黄体酮避孕是最好的. It is generally recommended that women with PH have tubal ligation or use the Mirena IUD. 请参阅 节育与怀孕 了解更多信息.

额外的预防措施

PAH患者通常会采取额外的预防措施. 这些措施包括在航空旅行中补充氧气, 严重呼吸道感染的抗生素治疗, pneumococcal pneumonia vaccine and yearly flu vaccines (since pneumonia can be very serious with PH patients). 还要避免环境氧浓度可能降低的条件, 比如高海拔和在无增压的飞机舱内旅行. Before starting an exercise program, ask your physician what activities are appropriate for you. 最后, 如果你已经开始治疗多环芳烃, stopping any of your medicines without your physician's approval can be extremely dangerous. Medical therapy has significantly improved the outlook for most patients with pulmonary hypertension, 但这并不能“治愈”它. Don't stop medical therapies unless your physician (trained in caring for PAH patients) recommends doing so.

预防心内膜炎

People with PH and certain underlying congenital heart defects may need antibiotics before certain dental procedures to prevent 心内膜炎. As the 心内膜炎 recommendations have changed, please discuss with your cardiologist.

了解更多:

• 有关PH的更多信息，请访问 phassociation.org(链接在新窗口中打开).