How Is PH diagnosed?There is no one specific test that will show why you have PH. Even in its later stages, the signs of the disease are similar to those of other heart and lung conditions. Your doctor will determine if you have PH by conducting a series of tests to determine the pressure in your pulmonary artery, find out how well your heart and lungs are working, and rule out any other conditions that may be causing the hypertension
These tests include a chest x ray, which can show if the pulmonary arteries or the right side of the heart are enlarged. It will also help your doctor rule out a number of lung diseases, including chronic obstructive pulmonary disease (COPD), as the cause of your PH.
An EKG (electrocardiogram) is used to measure the rate and regularity of your heartbeat, as well as the size and position of the right ventricle in your heart. It can help the doctor rule out a number of diseases of the heart.
An echocardiogram uses sound waves to create a moving picture of your heart. Echocardiogram provides information about the size and shape of your heart and how well your heart chambers and valves are functioning. The test also can identify areas of poor blood flow to the heart, areas of heart muscle that are not contracting normally, and previous injury to the heart muscle caused by poor blood flow.
Some heart problems are easier to diagnose when your heart is working harder and beating faster than when it’s at rest. During a stress test, you exercise (or are given medicine if you are unable to exercise) to make your heart work harder and beat faster while heart tests are performed. During exercise stress testing, your blood pressure and EKG readings are monitored while you walk or run on a treadmill or pedal a bicycle. Other heart tests, such as nuclear heart scanning or echocardiography, also can be done at the same time. These would be ordered if your doctor needs more information than the exercise stress test can provide about how well your heart is working.
Spirometry is a test which measures how well your lungs inhale and exhale air. It is most useful for ruling out obstructive lung diseases like COPD.
Cardiac catheterization provides a precise measure of the blood pressure in the right side of your heart and the pulmonary artery. Cardiac catheterization is the only way to get this measure. It also shows the amount of blood the right ventricle pumps with each heartbeat. This helps your doctor evaluate the pumping ability of the right ventricle. This procedure must be performed in the hospital by a specialist.
Usually, these tests are sufficient to confirm that you have PH. Sometimes these tests do not rule out all possible causes for PH.
What Are the Signs and Symptoms of PH?
Difficulty breathing or shortness of breath is the main symptom of PH. You may feel that it is difficult to get enough air.
You may experience fatigue, dizziness, or fainting spells.
Swelling in the ankles or legs may occur; or bluish lips and skin, chest pain, a racing pulse or palpitations.
As the disease advances, the pumping action of your heart grows weaker. Your energy decreases.
In the more advanced stages, you are able to perform very little activity, and have symptoms even when resting.
What are the treatments for PH?
If PH is caused by a known factor, treat that underlying cause. Reduce symptoms and improve quality of life. Slow the growth of the smooth muscle cells and the development of blood clots. Increase the supply of blood and oxygen to the heart, while reducing its workload.
Medications may be prescribed, including anticoagulants, calcium channel blockers, diuretics, and prostacyclin.
Oxygen is helpful at times, and lung transplantation may be discussed when other treatments are not working.
It is extremely important to get a proper diagnosis, AND to find a doctor with experience handling this disease. There is a local support group for PH.
The patient should try to remain positive, and to know more treatments for this disease are on their way!