Daily health tips for children with pulmonary hypertension

What do you need to bear in mind if you look after a child with pulmonary hypertension?

It is important to take into account the following:

• Being familiar with the symptoms
• Having a balanced diet
• Adapting to physical activity
• Preventing infections

Pulmonary hypertension requires highly specialised treatment, therefore, each case needs to be treated in reference units with a multidisciplinary team.

Nursing staff equip the child’s main carers and, depending on their age, the child, with the knowledge, skills and aptitudes they need to manage and treat the condition at home.

Possible signs and symptoms

Although the main symptom is difficulty breathing, initially following exercise and later when resting, the symptoms in paediatrics are non-specific and depend on the age of the child and the evolution of the illness:

• Breastfeeding babies: they may show signs of tiredness when feeding, frequent vomiting, irritability, slow growth and weight gain, quicker breathing and heart beating faster than normal; chest pain may manifest in crying fits and bluish discolouration of skin, mucous membranes and fingers (cyanosis).
• Pre-school children: the most common symptoms are fatigue with ease and lack of breath during physical effort; the skin and lips may have bluish discolouration,
• In children older than ten years and advanced cases: swelling may appear on the ankles and legs, the liver is enlarged and swelling of the finger and toe tips (acropachy).

To improve the signs and symptoms, we recommend

• Having a balanced diet
  • Both being overweight and being under-nourished can affect the control of this illness, limit daily activities and increase breathing and heart complications and infections.
  • Diet should be varied, low in salt and saturated fats and high in fibre, prevent constipation to avoid over exertion.
• Adapting to physical activity
  • Intense physical activity may increase pulmonary artery pressure. Activities that bring on symptoms should therefore be avoided and you should look out for signs of fatigue.
  • Adaptation to exercise should be slow and gradual. Increase frequency and intensity from slight to moderate depending on how the infant tolerates it.
  • Any activity that causes dizziness or shortness of breath should be immediately stopped.
• Preventing infections
  • Infections worsen the child’s general condition and aggravate the symptoms of the illness:
    • Hand hygiene: hands should be washed regularly.
    • Oral hygiene: clean teeth after every meal.
    • Vaccinations: respiratory infections are poorly tolerated and must be treated early. Seasonal vaccinations of flu and pneumococcal pneumonia are recommended for both the patient and their cohabiting family.

Look out for the following warning signs and, if they appear, see a doctor:

• Difficulty breathing which leads to frequent interruptions during intake of breath.
• Unexplained weight gain (900 g a day or > 2 kg a week)
• Increased swelling of the ankles, feet, legs or abdomen
• Extreme fatigue or decreased tolerance of physical activity
• Shortness of breath that does not improve with rest