Vital Facts on Pulmonary Hypertension

Pulmonary hypertension is a specific type of high blood pressure that affects  the arteries leading from the heart to the lungs. It is different from ordinary high blood pressure or hypertension, which is a risk factor for heart disease and stroke and can be easily monitored, even at home.

Pulmonary hypertension is not as common and much harder to diagnose because its key symptom – shortness of breath – can signal other conditions affecting lungs or the cardiovascular system.

“Many other conditions, including heart disease, COPD (chronic obstructive pulmonary disease) and rheumatic diseases, can have shortness of breath as a major indicator,” said Javier Jimenez, M.D., cardiologist at South Miami Hospital and director of the Pulmonary Hypertension Program. “Because of this, diagnosis of pulmonary hypertension is often delayed.”

Dr. Jimenez says that when shortness of breath and fatigue are “out of proportion to your level of fitness and your age” – and appear to be getting worse – those two symptoms could  indicate pulmonary hypertension.

There are several types of pulmonary hypertension, or PH, but the general condition often sends a patient from a primary to a pulmonologist and then to a cardiologist – before it is treated effectively. Pulmonary arterial hypertension (PAH) is the rarest type, affecting 1 in 100,000 to 1 in 1 million people, but it can be life-threatening.

Pulmonary arteries carry blood that has returned from the body to the lungs, where the blood receives a fresh supply of oxygen. When hypertension strikes those arteries, high blood pressure puts a strain on the heart .

Diagnosis of Pulmonary Hypertension
Most often, a person with undiagnosed PH visits the doctor for shortness of breath. The doctor then seeks the cause, gathering information through medical history and diagnostic tests such as an echocardiogram, an ultrasound picture of the beating heart. An echocardiogram can estimate pulmonary artery pressures and check the function of the heart’s right and left ventricles.

However, after diagnostics, lab work and a thorough review of family history, a “right heart catheterization” may be required to measure the blood pressure in the pulmonary arteries directly.

South Miami Heart Center’s Pulmonary Hypertension Program offers a team approach for treating the different types of PH, infusing feedback from pulmonologists, cardiologists and other specialists.  And that’s the best approach, considering the complexity of the pinpointing the condition and administering treatment, said Dr. Jimenez,

“Ten years ago, there was one drug to treat PH. Now there are 10 different drugs,” he said. “The South Miami Heart Center program tailors the right care for a patient with a rare and complex condition that can require expensive drugs.  The team approach is the best treatment.”

Symptoms That May Signal Pulmonary Hypertension

Breathing Difficulties:

  • Shortness of breath from walking up stairs or simple activities (dyspnea).
  • Trouble breathing when resting or lying down.
  • Waking up breathless at night (paroxysmal nocturnal dyspnea).
  • Needing more than two pillows to sleep (orthopnea).
  • Low oxygen saturations on room air.
  • Fatigue/Exercise Intolerance:

  • Tiring easily.
  • Swelling of feet, ankles or legs (edema).
  • General feeling of fatigue.
  • Swollen abdomen (ascites).
  • Rapid, hard or irregular heartbeats (palpitations).
  • Dizziness and or/fainting (syncopy).
  • Pulmonary Hypertension Risk Factors

  • Heart disease.
  • Secondary PH: associated with lung diseases such as COPD; pulmonary fibrosis, sleep apnea.
  • Liver disease.
  • Connective tissues diseases like scleroderma or lupus.
  • Certain drugs such as appetite suppressants or illegal stimulants as methamphetamines (speed) or cocaine.
  • Family history of PAH (pulmonary arterial hypertension).
  • Viruses or unknown cause.
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