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Suggest Treatment For Pulmonary Hypertension
Question: I have second to third pulmonary hypertension, SOB on exertion, pulse of between 90 & 95, and asthma most days. My pulmonogist says if we can control my asthma and sleep apnea I should be fine. Should I get another opinion.
Brief Answer:
Yes, control of the cause of Pulmonary hypertension is important.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through your query I would like to comment the following:
1. You seem to have been diagnosed with asthma , Obstructive Sleep Apnoea (OSA) and Pulmonary hypertension.
2. It needs to be confirmed if it is severe Pulmonary hypertension or cor pulmonale (right ventricle dilation on 2d echo) has set in.
3. Also senile COPD needs to be differentiated from asthma as asthma is not frequently associated with Pulmonary hypertension. Routine review of medications, proper inhalation technique and spirometry monitoring are important.
4. OSA is associated with Pulmonary hypertension and a good control of OSA does help in management of Pulmonary hypertension.
5. There are specific medicines for Pulmonary hypertension but not with a proven role if it is secondary to any etiology.
6. It is recommended that you get a detailed clinical evaluation by Pulmonologist and a confirmation of diagnosis. Repeat sleep study may be required to gauge your response to call and if required pressures may be changed if it is a manual C-pap and not auto C-pap.
I hope, I have answered your query. I would be glad to answer follow up query if any.
Dr. Mishra
MBBS MD DNB MNAMS
Consultant Pulmonologist
Yes, control of the cause of Pulmonary hypertension is important.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through your query I would like to comment the following:
1. You seem to have been diagnosed with asthma , Obstructive Sleep Apnoea (OSA) and Pulmonary hypertension.
2. It needs to be confirmed if it is severe Pulmonary hypertension or cor pulmonale (right ventricle dilation on 2d echo) has set in.
3. Also senile COPD needs to be differentiated from asthma as asthma is not frequently associated with Pulmonary hypertension. Routine review of medications, proper inhalation technique and spirometry monitoring are important.
4. OSA is associated with Pulmonary hypertension and a good control of OSA does help in management of Pulmonary hypertension.
5. There are specific medicines for Pulmonary hypertension but not with a proven role if it is secondary to any etiology.
6. It is recommended that you get a detailed clinical evaluation by Pulmonologist and a confirmation of diagnosis. Repeat sleep study may be required to gauge your response to call and if required pressures may be changed if it is a manual C-pap and not auto C-pap.
I hope, I have answered your query. I would be glad to answer follow up query if any.
Dr. Mishra
MBBS MD DNB MNAMS
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
I have had asthma since I was a child. I had a repeat sleep study and they increased the pressure from 10 to 12-16. They used big doses of steroids and then the inhaled steroids. It seems to me my asthma is worse with using the inhaled steroid. I have a constant need to clear my throat but nothing to exporate. The pulmonary doctor seems to think the PH is related to sleep apnea. I had a heart catch and that is when they found the PH. I have severe exertional SOB. I am just not feeling completely sure of my pulmonogist. This is a scary diagnosis.
Brief Answer:
PH is more likely to be associated with sleep apnea.
Detailed Answer:
Hi,
Thanks for the followup query. After going through the followup query, I would like to comment the following:
1. I agree with your Pulmonologist that Pulmonary hypertension is more likely to be associated with sleep apnea.
2. However, asthma if uncontrolled in the long run can also lead to this complication. Steroid resistant asthma, abpa, improper inhaler technique, or presence of alternative diagnosis are issues that need to be considered in case of uncontrolled asthma. I assume that your asthma is being monitored by Pulmonary function tests at regular intervals.
3. CPAP can be raised to a XXXXXXX pressure of 20. You need to maintain ideal body weight for your height,healthy lifestyle and proper compliance of the medications prescribed by your Pulmonologist.
I hope I have answered your query.
Wish you good health.
Dr. Mishra
MBBS MD Pulmonary Medicine
DNB Respiratory Diseases
Consultant Pulmonologist
PH is more likely to be associated with sleep apnea.
Detailed Answer:
Hi,
Thanks for the followup query. After going through the followup query, I would like to comment the following:
1. I agree with your Pulmonologist that Pulmonary hypertension is more likely to be associated with sleep apnea.
2. However, asthma if uncontrolled in the long run can also lead to this complication. Steroid resistant asthma, abpa, improper inhaler technique, or presence of alternative diagnosis are issues that need to be considered in case of uncontrolled asthma. I assume that your asthma is being monitored by Pulmonary function tests at regular intervals.
3. CPAP can be raised to a XXXXXXX pressure of 20. You need to maintain ideal body weight for your height,healthy lifestyle and proper compliance of the medications prescribed by your Pulmonologist.
I hope I have answered your query.
Wish you good health.
Dr. Mishra
MBBS MD Pulmonary Medicine
DNB Respiratory Diseases
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Yogesh D
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