Pulmonary Hypertension
The Pulmonary Hypertension (PH) Clinic located in The University of Toledo Heart and Vascular Center offers an innovative, multi-disciplinary approach to the diagnosis and treatment of PH. The PH Clinic combines the disciplines of cardiology, rheumatology and pulmonology to provide the most current, in-depth, and comprehensive evaluation and treatment available for PH.
PH is a progressive, complicated health condition that affects many Americans each year. PH affects people of all backgrounds. The signs and symptoms of PH can begin at any age. There are many possible causes for pulmonary hypertension, including heart disease, lung disease, or rheumatologic disease.
When PH is associated with heart disease, the lungs, or clot disorders, the condition can be life threatening and risk of overall poor health increases. To address this important condition, The University of Toledo has developed a new approach to management by creating a unique, multidisciplinary subspecialty clinic. Cardiology, rheumatology and pulmonary physicians work closely together to diagnose and treat this complex disease.
What is PH? PH is a condition which occurs when the pulmonary arteries become too narrow to accommodate the volume of blood that needs to be oxygenated by the lungs. As a result of this narrowing, the right side of the heart must pump harder to force enough blood to the lungs. Over time, the right side of the heart becomes overworked, which can lead to right heart failure. What causes PH? PH can be associated with heart diseases such as heart failure and valvular leakage. It is also associated with lung disease such as emphysema, and clotting diseases such as a clot in the leg or deep venous thrombosis, a blood clot that forms in a vein deep in the body. PH which occurs from an unknown cause is called idiopathic PH or pulmonary arterial hypertension (PAH).
Other common causes of PH include heredity, collagen vascular disease (scleroderma and/or lupus), congenital heart disease, cirrhosis, HIV, and drugs or toxins such as Phen-Phen, cocaine, speed, or methamphetamine. What are the signs/symptoms of PH? When PAH is present, the blood is carrying less oxygen than normal. During the early stages of PH, patients can be completely symptom-free. However, when oxygen levels in the blood are too low, symptoms such as shortness of breath, dizziness and fatigue (especially with activity) may develop. Other symptoms can include chest pain, swelling of the arms and legs, and Raynaud’s phenomenon, where cold temperatures can cause blood vessel spasms that block blood flow to the fingers, toes, ears or nose. How is PH diagnosed? PH is generally diagnosed through a series of tests which may include:
- Chest X-ray
- Echocardiogram, which uses sound waves to create an image of the heart
- Right Heart Catheterization, which allows specialists to view inside the right chambers of the heart
- 6MWD (a six-minute walk distance test)
How is PH Treated? Individualized treatment plans are developed to address a patient’s specific cause and type of pulmonary hypertension. In addition, the treatment of PH depends on many factors including severity, symptoms, and a patient’s individual needs.
The World Health Organization (WHO) has developed a categorization system called the WHO Functional Class. This system is used to determine the severity of a patient’s PH and serves as an effective guide to develop quality, individualized treatment plans.