Pulmonary hypertension (PH)

• Pulmonary hypertension in the newborn
  Pulmonary hypertension means abnormally high blood pressure in the arteries of the lungs. In these newborn babies (about 0.2% of live births), the changes which normally happen to the circulation at birth do not occur and circulation continues in the same way as before birth. This means that blood flows in the wrong direction through the newborn baby’s heart. It is a very serious situation requiring early surgical treatment since inadequate oxygen reaches the baby’s vital organs. PH in the newborn is sometimes due to asphyxia (lack of oxygen) of the baby during the birth process, infection, congenital heart disease or incomplete development of the lungs. When there is no known cause it is referred to as Primary Pulmonary Hypertension

• Pulmonary hypertension in childhood
  Pulmonary hypertension, occurring later in childhood, is usually a late complication of a severe lung problem, such as cystic fibrosis, lung fibrosis or obstructive sleep apnoea. It may also complicate diseases of the nerves and muscles or congenital heart disease. Otherwise it may arise as an abnormality of the lung arteries themselves – either clots arising in the lung blood vessels, or clots travelling through the circulation from elsewhere (emboli). Occasionally, emboli are formed not of blood clot, but are clumps of infected material which have broken off and travelled in the blood from some abscess elsewhere. Lung clots may also be due to abnormalities of blood clotting and very rarely PH is due to an abnormal overgrowth of tiny vessels (invasive pulmonary capillary haemangiomatosis).

PH is difficult to diagnose and very difficult to treat.