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What Does High Pulmonary Artery Pressure When Suffering From CHP Indicate?
Question: i have been diagnosed with CHP. my dlco is around 38% to 42%. my pulmonary artery pressure is 31. I have atypical basilar fibrosis. Normally I exercise for about 40 to 45 minutes a day with some desaturation but O2 sat returns to normal quickly. About twice a year I get an upper lung cold or exacerbation which then requires some time to return to normal functioning without desaturating. Then I am fine again. Can I expect to get better? The antigen was never identified.
Brief Answer:
kindly go through the discussion below
Detailed Answer:
Hello
Thanks for your query.
Chronic HP is a fibrosing disease of lung. That's why your DLCO is low. Your pulmonary artery pressure is slightly high. It indicates that you already have developed pulmonary arterial hypertension. Your disease has already progressed. You probably have some fibro-cavitary lesion in your lung that is causing few exacerbations. You should have a HRCT (high resolution computed tomography) scan of thorax which will reveal some fibro-cavitary changes. If it really happens then chance of reversibility is less. You may suffer from few exacerbations every year. I advise you to have a HRCT scan thorax immediately to have a detailed look on your lung parenchyma.
If you have further queries you can write back to me.
Regards,
Dr Arnab Maji
MBBS (Hons), MD
Consultant Pulmonologist
kindly go through the discussion below
Detailed Answer:
Hello
Thanks for your query.
Chronic HP is a fibrosing disease of lung. That's why your DLCO is low. Your pulmonary artery pressure is slightly high. It indicates that you already have developed pulmonary arterial hypertension. Your disease has already progressed. You probably have some fibro-cavitary lesion in your lung that is causing few exacerbations. You should have a HRCT (high resolution computed tomography) scan of thorax which will reveal some fibro-cavitary changes. If it really happens then chance of reversibility is less. You may suffer from few exacerbations every year. I advise you to have a HRCT scan thorax immediately to have a detailed look on your lung parenchyma.
If you have further queries you can write back to me.
Regards,
Dr Arnab Maji
MBBS (Hons), MD
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
have had several CT scans and the only thing it shows is expiratory basilar ground glass opacities. My dlco used to be 23% and XXXXXXX to 43% over the past 9 months. 31 is a very slight elevation of pulmonary artery pressure, is it not? My thoracotomy lung samples were sent to Mayo and examined by U of M. This is how the diagnosis of CHP with atypical basilar fibrosis was made. I was led to believe that once the antigen was removed, I should get better.
Brief Answer:
Fibrosis is irreversible but not ground-glass
Detailed Answer:
Hello,
Thanks for writing back and also for detailed history of your disease.
Ground glass shadow is found in HP. 31 mmHg is really a very mild elevation of pulmonary arterial pressure. But one thing you mentioned here is that there is presence of atypical basilar fibrosis. Once fibrosis is developed it persists even after knowing the culprit antigen. Fibrosis is an irreversible process and it will cause chronic problems. Ground glass opacity is a reversible disease process finding and fibrosis is an irreversible process. I hope I have been able to convey my massage to you. So even after identification of antigen fibrosis will persist and that will give rise to intermittent chronic problems. But identification of antigen and appropriate avoidance of that will prevent surely further progression of disease.
If you have further queries you may ask me.
Get well soon. Go through pulmonary rehabilitation programme to improve your quality of life.
Thank you.
Regards,
Dr Arnab Maji
MBBS (Hons), MD
Consultant Pulmonologist
Fibrosis is irreversible but not ground-glass
Detailed Answer:
Hello,
Thanks for writing back and also for detailed history of your disease.
Ground glass shadow is found in HP. 31 mmHg is really a very mild elevation of pulmonary arterial pressure. But one thing you mentioned here is that there is presence of atypical basilar fibrosis. Once fibrosis is developed it persists even after knowing the culprit antigen. Fibrosis is an irreversible process and it will cause chronic problems. Ground glass opacity is a reversible disease process finding and fibrosis is an irreversible process. I hope I have been able to convey my massage to you. So even after identification of antigen fibrosis will persist and that will give rise to intermittent chronic problems. But identification of antigen and appropriate avoidance of that will prevent surely further progression of disease.
If you have further queries you may ask me.
Get well soon. Go through pulmonary rehabilitation programme to improve your quality of life.
Thank you.
Regards,
Dr Arnab Maji
MBBS (Hons), MD
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
thank you for writing back. one last question. because i do have "atypical basilar fibrosis", does this mean the fibrosis will continue upward even if the antigen has been removed, or is it possible for it to just stay at the same level for the rest of my life? i will get pulmonary rehab. thank you for that idea. XXXXXXX XXXXXXX
Brief Answer:
Difficult to say
Detailed Answer:
Hi
Thanks for your query.
It's really very much tough to predict the course of the disease beforehand. But I personally do believe that if antigen exposure is ceased and proper treatment is taken the chance of progression of fibrosis will be less but the complications of the already existing fibrosis will always be there. Another issue I must stress upon here. You may have vaccination against pneumococci and yearly influenza vaccination. Because these will reduce the rate and fatality of subsequent lung infections. Pulmonary rehabilitation will increase your quality of life and working capacity for sure.
If you are satisfied with my answer, kindly write a review for my answer.
Thank you.
Regards,
Dr Arnab Maji
Consultant Pulmonologist
Difficult to say
Detailed Answer:
Hi
Thanks for your query.
It's really very much tough to predict the course of the disease beforehand. But I personally do believe that if antigen exposure is ceased and proper treatment is taken the chance of progression of fibrosis will be less but the complications of the already existing fibrosis will always be there. Another issue I must stress upon here. You may have vaccination against pneumococci and yearly influenza vaccination. Because these will reduce the rate and fatality of subsequent lung infections. Pulmonary rehabilitation will increase your quality of life and working capacity for sure.
If you are satisfied with my answer, kindly write a review for my answer.
Thank you.
Regards,
Dr Arnab Maji
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Raju A.T
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