Most of us have heard of hypertension, also known as high blood pressure. While nearly half of U.S. adults have high blood pressure, there’s another, lesser-known type of hypertension called pulmonary hypertension (PH). Pulmonary hypertension refers to high blood pressure in the lungs, and it can’t be detected with regular blood pressure screening. We spoke with physicians from WakeMed Heart & Vascular and WakeMed Pulmonology to learn more about this disease, who’s at risk, and the new and innovative treatments offered to patients.

Pulmonary Hypertension, Explained

Pulmonary hypertension is a form of lung disease where the blood vessels in the lungs are affected by high blood pressure. This increased pressure causes those vessels to become stiff, damaged, or narrow, which means the right side of the heart has to work harder to pump blood through. This is why many patients with PH also suffer from right-side heart failure – a condition that develops over time due to the stress on the heart muscle. Common risk factors include having a connective tissue disorder, congenital heart disease, being overweight, having congestive heart failure, COPD or pulmonary fibrosis, sleep apnea, and/or blood clots. However, it can also develop without these risk factors. Pulmonary hypertension is a chronic, progressive disease that can affect patients of all ages.

Signs and Symptoms

The most common symptom is shortness of breath, but others include fatigue; dizziness or fainting spells; chest pressure or pain; fast pulse or pounding heartbeat; swelling in the ankles, legs, and belly area; or blue/gray skin color due to low oxygen levels. Because symptoms often develop slowly over time, you may not notice them for months, or even years. That’s why it’s important to pay attention to even small changes in how you’re feeling and to talk to your doctor as soon as you notice them.

“Pulmonary hypertension is often overlooked and underdiagnosed,” says Daniel Fox, MD, a pulmonologist and critical care physician at WakeMed. “It’s a very complex condition that can take years to accurately diagnose and treat. Patients are often sent from specialist to specialist to get a wide range of diagnostic tests; all the while, their disease and symptoms are progressing, which can lead to a poor quality of life and frequent hospitalization.”

Early diagnosis can help patients get the treatments they need to lower the pressure in their lungs, improve heart function, and alleviate symptoms. If left untreated, pulmonary hypertension can lead to heart failure, arrhythmias such as atrial fibrillation, blood clots, and pregnancy complications. Diagnosis starts with blood tests and imaging of the heart and can require additional testing, including right-side heart catheterization. The good news is that while the condition often can’t be cured, treatment options have come a long way in recent years, thanks to a better understanding of how to approach it.

Treatment for Pulmonary Hypertension

It’s important to receive treatment from a doctor who specializes in pulmonary hypertension to ensure that you are getting the most up-to-date treatment options. While diseases of the heart and lungs go hand in hand, in most cases, patients are treated by one or more specialists with infrequent collaboration or communication. A more coordinated approach to caring for patients with PH can help bridge the gap between early recognition and effective treatment. “Pulmonary hypertension is a condition that falls at the intersection of cardiology and pulmonology, and it only makes sense that the most effective care requires a collaborative approach,” explains pulmonary vascular expert Kishan Parikh, MD, WakeMed Heart & Vascular – Advanced Heart Failure. “We have the right people and tools to make a real difference in the lives of patients with pulmonary hypertension and previously unexplained shortness of breath.”

The WakeMed Heart Failure and Pulmonary Hypertension program is one of a kind in Wake County. Patients who previously had to travel to see specialists with expertise in managing this complex condition can now get the care they need closer to home.

WakeMed Pulmonology offers traditional pulmonology medicine services as well as pulmonary hypertension care and state-of-the-art interventional pulmonary procedures with offices in Raleigh, Cary, and Brier Creek.