Pulmonary Hypertension
Pulmonary hypertension (PH) is a serious condition that occurs when there is high blood pressure in the arteries that supply the lungs. Over time, this increased pressure makes it harder for the heart to pump blood through the lungs, leading to shortness of breath, fatigue, and dizziness.
PH may be caused by heart or lung disease, blood clots, or autoimmune conditions. The five major groups of PH include pulmonary arterial hypertension (PAH), left heart disease, lung disease–related PH, chronic thromboembolic PH (CTEPH), and multifactorial causes.
At The Medical Group of New Jersey, our pulmonologists use echocardiography, right heart catheterization, and advanced imaging to accurately identify the underlying cause and guide targeted therapy to improve function and longevity.
Symptom Onset & Initial Evaluation
Symptoms of pulmonary hypertension can develop slowly and may resemble other heart or lung problems, often delaying diagnosis. Common symptoms include:
- Shortness of breath during activity or at rest
- Chest discomfort or tightness
- Dizziness or fainting (syncope)
- Swelling in the ankles, legs, or abdomen
- Fatigue or reduced exercise capacity
During your initial consultation, your pulmonologist will perform a thorough exam, listen for heart murmurs, and assess for signs of right heart strain or fluid retention. They will also review your medical history and any predisposing conditions such as connective tissue disease or prior blood clots.
Diagnosis
Diagnosing pulmonary hypertension (PH) requires a thorough and coordinated evaluation to confirm elevated pressures in the lungs and determine what’s causing them. Because PH can result from heart disease, lung disease, blood clots, or other systemic conditions, accurate diagnosis is essential to guide treatment.
Your pulmonologist may recommend several tests, including:
- Echocardiogram (ultrasound of the heart): Estimates pulmonary artery pressure and evaluates how well the right side of the heart is pumping.
- Right heart catheterization: The gold-standard test that directly measures pressure in the pulmonary arteries.
- CT scan or V/Q scan: Detects blood clots or chronic lung disease contributing to high pressure in the lungs.
- Pulmonary function tests and oxygen studies: Assess overall lung capacity and oxygen exchange.
At The Medical Group of New Jersey, our pulmonologists work closely with cardiology and vascular specialists to coordinate all testing. This integrated approach ensures an accurate diagnosis and a personalized treatment plan tailored to the underlying cause of your pulmonary hypertension.
Treatment
Treatment depends on the type and cause of pulmonary hypertension, but the goal is to reduce pressure, relieve symptoms, and improve heart and lung performance.
Medical Therapy
- Vasodilators: Medications such as prostacyclin analogs, endothelin receptor antagonists, and PDE-5 inhibitors help relax and widen the pulmonary arteries to reduce pressure.
- Anticoagulants: Prescribed for clot-related pulmonary hypertension (chronic thromboembolic PH or CTEPH) to prevent further clot formation.
- Oxygen therapy: Provides supplemental oxygen for patients with low oxygen levels or coexisting lung disease.
- Diuretics: Help relieve swelling and fluid buildup by reducing strain on the heart.
Lifestyle & Supportive Care
Daily habits play a vital role in managing pulmonary hypertension. Your care team may recommend:
- Following a low-sodium diet to prevent fluid retention.
- Engaging in moderate, supervised physical activity to improve endurance and circulation.
- Avoiding high altitudes or air travel without supplemental oxygen when advised by your physician.
Advanced Options
For severe or treatment-resistant pulmonary hypertension, additional therapies may be considered:
- Balloon pulmonary angioplasty: A minimally invasive procedure that opens narrowed blood vessels in patients with CTEPH.
- Lung or heart-lung transplant: Reserved for advanced cases when other treatments are no longer effective.
Patients receive compassionate, evidence-based care from a multidisciplinary team dedicated to improving breathing, exercise tolerance, and long-term quality of life.
Ongoing Management & Prevention
Pulmonary hypertension requires long-term follow-up to monitor progress and adjust therapy. At The Medical Group of New Jersey, follow-up care includes:
- Regular echocardiograms or right heart studies
- Medication review and side-effect monitoring
- Nutritional and exercise counseling
- Coordination with cardiology and transplant specialists
With modern therapies and coordinated care, many patients experience improved exercise tolerance, reduced symptoms, and extended survival.