Pediatric persistent pulmonary hypertension

What is pediatric pulmonary hypertension?

Pulmonary hypertension occurs when high blood pressure builds up in arteries in the lungs, preventing the heart and lungs from working properly together.

In a healthy heart, the left side of the heart takes oxygen-rich blood from the lungs and pumps it throughout the body. When blood returns to the heart to get more oxygen, the right side pumps the blood through the pulmonary arteries into the lungs where blood picks up oxygen again.

When a child has pulmonary hypertension, the right side of the heart becomes enlarged, due to working overtime to pump blood back into the lungs. Muscles in the lung’s blood vessels also begin to thicken, rather than remain flexible, making it harder to pump blood through the lungs. This puts additional strain on the heart and can eventually lead to heart failure if not treated.

What are the signs and symptoms of pediatric pulmonary hypertension?

Symptoms of persistent pulmonary hypertension include:

• Bluish-colored skin after birth (cyanosis)

• Chest pain 

• Decreased appetite

• Fatigue

• Feeling light headed or passing out

• Low blood oxygen levels

• Rapid breathing

• Racing or pounding heart 

• Severe respiratory distress (trouble breathing)

• Shortness of breath during routine activity 

• Swelling of feet and ankles

• Bluish-colored skin after birth (cyanosis)

• Weak pulse

What are the causes of pediatric pulmonary hypertension?

When a child has pulmonary hypertension, blood pressure on the right side of the heart is too high due to either a lung or a heart problem.

Persistent pulmonary hypertension occurs most often in post-term (past 40 weeks’ gestation) infants, but it can happen in any infant (birth to 1 year).

Causes may include:

• Meconium aspiration syndrome

• Pneumothorax (collapsed lung)

• Pneumonia

• Poor blood vessel dilation, caused by large doses of aspirin taken by the mother before delivery

• Respiratory distress caused by certain drugs taken by the mother before delivery

• Response to stress during delivery