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Pulmonary Hypertension

Treatments for PH

05/13/2008

Question:

I have seen my cadiologist and she said that my PH is mild and that the pressure is not very high. I am still getting tests done, but I have no symptoms of PH. She has scheduled an ECHO every year. But she has not given me any type of treatments. Is it normal to wait and see what the test comes back as? Is all PH treated or is it okay to just keep an eye on it and treat it if it gets worse? Are there side effects from the treatments and could that be the reason for the delay in treatments? I thought that if we caught it early and treated, it was a better outcome.

Answer:

Pulmonary hypertension is diagnosed by heart catheterization. Although the echocardiogram is a useful test and provides a lot of information, it has its limitations. Ideally, you would undergo at least one heart catheterization at some point. I would not start treatment without first undergoing a heart catheterization to be certain of the diagnosis and to be aware of how severe the disease is. You are correct that not all patients with PH follow the same course and not all will develop severe disease. There are costs, risks, and side effects associated with medications for PH and because of these factors, I would not recommend starting medication solely on the basis of an echocardiogram result. Although it has not been directly proven, certainly it may be reasonable to think that initiating aggressive treatment early in the disease might lead to a better outcome.

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Response by:

Douglas W Haden, MD Douglas W Haden, MD
Assistant Professor
College of Medicine
The Ohio State University