Pulmonary Hypertension

WHAT IS PULMONARY HYPERTENSION? Pulmonary hypertension is a serious disease in which the pressure in the pulmonary arteries is high.

WHAT IS PULMONARY HYPERTENSION CAUSED BY?  Pulmonary hypertension can be caused by many things.  When we do not know the cause of pulmonary hypertension it is called idiopathic pulmonary hypertension.  This type of pulmonary hypertension is very rare and the prognosis not as good as secondary pulmonary hypertension.

When we know the cause of pulmonary hypertension it is called secondary pulmonary hypertension.  Causes of secondary pulmonary hypertension include collagen vascular diseases (such as scleroderma or lupus), lung diseases (such as COPD), congenital heart disease, chronic pulmonary embolism, HIV, liver disease and diet drugs like fenfluamine and dexfenfluramine.  Another form of pulmonary hypertension can be a result of congestive heart failure.

WHAT ARE THE SYMPTOMS OF PULMONARY HYPERTENSIONShortness of breath, fatigue, chest pain and dizziness are common symptoms of pulmonary hypertension.

HOW IS PULMONARY HYPERTENSION DIAGNOSED?  Usually, an echocardiogram of the heart is done to evaluate for pulmonary hypertension.  Once pulmonary hypertension is suspected from the echocardiogram, a right heart catheterization is usually required to confirm the diagnosis.  Other tests are done to investigate other diseases (collagen vascular diseases, COPD, etc.) which could cause pulmonary hypertension.

HOW IS PULMONARY HYPERTENSION TREATED?  Pulmonary hypertension is treated differently depending on the cause.  In cases where pulmonary hypertension is due to left heart failure (congestive heart failure), then treatment would be targeted toward standard heart failure treatment.  If the cause is COPD then standard COPD treatment and oxygen would be the treatment.  Anticoagulation (thinning of the blood) may be necessary in some cases.  In patients with idiopathic or collagen vascular related pulmonary hypertension, specialized treatment for dilating the pulmonary artery is indicated.

WHAT CAN I EXPECT ON MY FIRST VISIT TO PCCS? Pulmonary function testing, lab work and a chest x-ray will be done to evaluate for causes of pulmonary hypertension.  A medical history will be taken, a cardiogram and physical exam will be done.  Some follow up tests may be ordered depending on the individual case such as an echo or right heart catheterization, a sleep study, a nuclear study of the lungs, and a walking test.