Dr. Miller: You've just been diagnosed with pulmonary hypertension and you wonder about the next steps. We're going to talk about that next on Scope Radio.
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Dr. Miller: Hi, I'm Dr. Tom Miller and I'm here with Dr. Nate Hatton today. Nate is a pulmonary specialist or lung doctor. Nate, you run a specialty clinic taking care of patients that have pulmonary hypertension. Tell me a little bit about the difference between pulmonary hypertension and what we know as hypertension, or high blood pressure, in the population.
Pulmonary Hypertension vs. High Blood Pressure
Dr. Hatton: The real difference between those two deals with where the blood flow is coming from. In systemic hypertension or laymen's hypertension, that blood flow is from the left side of the heart. And that's, that's when you feel your pulse in your wrist. That's the high-pressure system within our body.
Dr. Miller: And that's the common type of blood pressure that we're mostly aware of as the public might know it.
Dr. Hatton: Correct. Correct. When you go into your doctor's office and they put the cuff on your arm, that's the blood pressure we're measuring.
What Is Pulmonary Hypertension?
Dr. Miller: What is pulmonary hypertension, then?
Dr. Hatton: Pulmonary hypertension is really blood flow into the lungs, which is much more difficult to measure. The blood flow that goes into the lungs comes from the right side of the heart, and that's a very low pressure system. And normally it's almost tenfold times lower than what it would be otherwise.
Dr. Miller: So you might not know you have pulmonary hypertension just by taking your blood pressure in the usual way by putting a cuff around your arm and having somebody read the blood pressure?
Dr. Hatton: Yeah, that's very true. They are totally unrelated. You would have no idea that you could have pulmonary hypertension. When we measure it in the doctor's office, it could be totally normal.
Symptoms and Effects of Pulmonary Hypertension
Dr. Miller: Many people know that high blood pressure eventually can lead to heart attacks and strokes. Is that true for pulmonary hypertension? And what actually happens in folks that have pulmonary hypertension?
Dr. Hatton: So pulmonary hypertension typically presents with shortness of breath and so that's your most common presenting sign or symptom. And it does similar things. It's difficult on the heart over time. So it doesn't necessarily cause strokes, but it definitely causes a lot of stress on the heart and continues to sort of . . . as it gets worse, ultimately leads to heart failure with time.
Treating Different Types of Pulmonary Hypertension
Dr. Miller: So let's say a patient comes to you has been diagnosed with pulmonary hypertension. In general, what's next for them as they come to see you?
Dr. Hatton: Sure.
Dr. Miller: What do you do basically to help them get better?
Dr. Hatton: There are lots of different types of pulmonary hypertension. There is pulmonary hypertension that can be caused from other heart problems, like valve disease. There is pulmonary hypertension that can be caused from lung disease or if you have blood clots. So in our clinic, what we really focus on is trying to decide where the problem is, whether it's the blood vessels in the lungs, the heart, or you have, for instance, COPD or another lung disease, and really focus on where the problem is to decide what the best therapy would be at that time.
Dr. Miller: One of the things I really like about your clinic is you have a cardiologist whom you work with that together you guys really tackle pulmonary hypertension in its various presentations and causes, which seems to be a potential bonus for patients coming to this particular specialty clinic.
Dr. Hatton: Dr. Ryan and I, I'm a pulmonologist lung doctor. He's a cardiologist, so he focuses on the heart. We sit down and review all of our patients' data, all of the tests that we've done, and sort of make our best determination what we think is truly causing the pulmonary hypertension and then focus therapies.
Dr. Miller: So it sounds like with appropriate therapy from dedicated specialists, this is going to be a better pathway for a particular patient with pulmonary hypertension than not coming in.
Dr. Hatton: We have a large sort of clinical staff and a team that our goals as clinicians are really to make you feel better. Right? And the most common symptom is shortness of breath and fatigue, and just sort of not feeling you can do what you used to be able to do or want to do. And so we have lots of therapies for pulmonary hypertension that can help with those symptoms and hopefully improve your quality of life, which is the main goal.
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updated: February 13, 2019
originally published: February 9, 2016
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