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Pulmonary Hypertension

Obesity and PH, more info.

04/22/2008

Question:

I am the 57y/o female with a 50 SPAP on echo. Extensive testing has failed to find a cause for my PH and I am classified as IPAH. Other medicals problems I have are: Type II diabetis x 2 years, asthma, a-fib, sleep apnea on c-pap x 4 years, metabolic syndrome, systolic hypertension, osteoarthritis, GERD, Fibromyalgia, Chronic Fatigue Syndrome, 14 allergies to tree, plant and grass pollens as well as cat dander, mold, dust mites and soy and Hashimoto`s thyroiditis. I have 6 very good specialists. My questions are: 1. Would losing weight ( i have a BMI over 40) really "cure" my PH? 2. I am at NY classification of I-II as far as function, is medication considered helpful at this stage? 3. Would you recommend that I go to a PH clinic? I live in San Antonio which has excellent medical facilities but no PH clinic. Thank you so much for your time, this is really a difficult issue for me.

Answer:

Before making a diagnosis of IPAH, it would be important to perform a right heart catheterization to assess the pressures. Given your multiple medical problems (diabetes, sleep apnea), the high pressure may be related to stiffness of the left side of the heart and the sleep apnea. In that case, losing weight and controlling the other problems well would improve the pressures. On the other hand, if the pressures are more consistent with what we find with IPAH, you may need to be started on treatment. You may want to discuss one visit to the PH clinic with your doctor.

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Response by:

Namita   Sood, MD, FCCP Namita Sood, MD, FCCP
Associate Professor of Pulmonary, Critical Care & Sleep
College of Medicine
The Ohio State University