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Dr. Neil Ettinger, St. Luke's Hospital

Learn the signs of pulmonary hypertension

A recent study has shown that pulmonary hypertension (PH), or abnormally high blood pressure in the arteries of the lungs, affects approximately four times as many women as men in the United States. One of the most alarming findings of the study is that those with the disease were likely diagnosed many months after the first sign of symptoms.

PH develops when tiny arteries in your lungs become narrow or blocked. This causes increased resistance to the flow of blood in the lungs, which in turn raises pressure within the blood vessels and creates what could be termed "high blood pressure of the lungs." As a result, the right side of the heart, which pumps blood into the lungs, has to pump against a higher resistance to blood flow. This makes it more difficult to pump the blood through the lungs, eventually causing the heart muscle to weaken and sometimes fail completely.

Pulmonary arterial hypertension (PAH) describes PH in people with no obvious cause of elevation in pulmonary artery pressures. It is less common than PH.

There are many causes of PH including:
  • Autoimmune diseases such as scleroderma, lupus and rheumatoid arthritis
  • Cardiac birth defects
  • Certain diet medications
  • Blood clots in the lung that fail to resolve
  • HIV infection
  • Lung diseases, including pulmonary fibrosis or advanced emphysema
  • Heart valve disease
  • Cirrhosis of the liver
Symptoms of PH:
  • Exertional shortness of breath
  • Fast heart rate (palpitations)
  • Ankle and leg swelling
  • Chest pain or pressure
  • Dizziness or fainting spells
  • Fatigue
The cause of PH is diagnosed through various testing methods, including a chest X-ray, CT scan of the chest, pulmonary function test, echocardiogram and nuclear lung scan. Ultimately, a cardiac catheterization is necessary.

Currently, there are many treatments for PH but no cure. Clinical studies are currently in progress to identify new treatments for this progressive disease.

Dr. Neil Ettinger is a pulmonologist at St. Luke's Hospital. To learn more about lung disease or to participate in a free PH study, call
314-439-LUNG (5864) or visit the CardioPulmonary Research Center page.

This article was published in the St. Louis Post-Dispatch on August 11, 2011.

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