Mercy Clinic Pulmonology – Joplin diagnoses and treats a variety of common lung conditions and diseases including emphysema, pneumonia and asthma, but pulmonary hypertension potentially is the most underdiagnosed pulmonary disorder in the Joplin area.
“Most people don’t know about it,” Dr. Festus Ndukwu said, “but if someone has pulmonary hypertension, they could die from it in three years if it goes untreated.”
Pulmonary hypertension in simplest terms is high blood pressure of the lungs. Specifically, it means high blood pressure in the heart-to-lung system that delivers oxygenated blood to the heart while returning oxygen-depleted blood back to the lungs. It’s characterized by the weakening of the right side of the heart, which contains the pulmonary artery.
Patients suffering pulmonary hypertension often visit their primary care physician complaining of shortness of breath, Dr. Ndukwu said, because the disorder forces the body to function on low oxygen levels. It’s often diagnosed as asthma, but when symptoms don’t improve after three months, patients are referred to a pulmonologist.
A patient has mild pulmonary hypertension when a test, such as a non-invasive echocardiography that is an ultrasound of high-pitched sound waves, measures 25 or more millimeters of mercury pressure. Patients with a reading of 30 to 40 have moderate hypertension, while 40 to 50 is severe hypertension.
“It can go above that range, though. Some can have up to 90 or 100 because when the pressure is high on the right side of the heart, it causes the right atrium and ventricle to dilate and become bigger,” Dr. Ndukwu said. “These patients are at risk of going into right heart failure. They could have pulmonary edema (excess fluid in the lungs), and their oxygen would be very low because the heart is too weak to supply oxygen to the body. The worst-case scenario is death.”
To manage moderate to severe pulmonary hypertension, patients are put on oxygen and given heart vessel-dilating medications to avoid clotting. Surgery can be an option in some situations, like when blood clots make it difficult for blood to circulate.
In many cases, pulmonary hypertension is inherited or the cause is unknown. Two known causes are smoking and heavy stimulants that contain fenfluramine derivatives such as the weight-loss drug phentermine. Another cause is sleep apnea, where the body accumulates carbon dioxide and has low oxygen levels, resulting in vessel restrictions and changes in the size, shape, structure or function of the heart. People who have autoimmune diseases such as HIV and collagen vascular disease also are susceptible.
People who experience shortness of breath or have one of the known causes should see their doctor.
“The sooner we can catch pulmonary hypertension,” Dr. Ndukwu said, “the better the chances we can resolve the problem.”
In addition to pulmonary hypertension, Dr. Ndukwu specializes in critical care, COPD, sleep medicine, asthma and lung nodules. He is board-certified in pulmonology/critical care and sleep disorders.