Pulmonary Venous Hypertension

Pulmonary venous hypertension (PVH) differs from PAH in that high blood pressure occurs when the heart can’t efficiently carry blood away from the lungs.  This results in blood collecting in lung tissue.  This is generally caused by diseases of the left side of the heart.   One such disease is endomyocardial fibrosis.  Fibrous connective tissue can accumulate in one or both ventricles and results in a constricted (narrowed) heart chamber.  This may also involve other heart structures such as the heart valves causing them to open and close abnormally.

Pulmonary Venous Hypertension Symptoms

PVH presents with many of the same symptoms seen in other forms of HP, however, it differs from PAH in that PVH’s shortness of breath occurs when a patient is in a reclined position or when sleeping.  Symptoms include:

  • Increased blood pressure
  • Fluid in the lungs and between the layers that surround the lungs and chest wall
  • Night breathing difficulty
  • Fatigue
  • Edema
  • Decrease in urine production
  • Coughing that may produce bloody mucus
  • Decrease in overall heart function

Pulmonary Venous Hypertension Diagnosis

Your healthcare provider will want to know about your medical and family history.  A physical exam will be administered to look for known symptoms of PVH such as a loud S2 (valve closure), jugular vein distention (jugular vein protrudes from the side of the neck), foot swelling and abdominal swelling (ascites).

Pulmonary Venous Hypertension Treatment

The goal is to try and treat the underlying causes.  To prevent congestive heart failure, medications such as beta blockers, ACE inhibitors and diuretics are used.  If a patient has structural heart issues, they may need surgical intervention.

Beta blockers block the effects of the sympathetic innervation of the heart.  This decreases the hearts workload, so it needs less blood and oxygen.  This aids in lowering blood pressure and helps to control abnormal beat rhythms that are either too fast or irregular.  ACE (angiotensin-converting enzyme) inhibitors block the enzyme that is needed to form a molecule that constricts blood vessels.  This allows blood vessels to relax allowing for easier flow of blood while reducing blood pressure.  Diuretics help to remove excess fluid from the body decreasing edema (swelling).

Pulmonary Venous Hypertension Prognosis

PVH survival rates are essentially no different from other forms of PH.  Depending on early diagnosis (if possible) and various therapies, an individual may survive somewhere between 3 to 10 years.