Pulmonary hypertension (PH) is high blood pressure in the lungs. When the blood vessels in the lungs become narrowed, the heart has to work harder to pump blood through them. It can cause the right side of the heart to function less efficiently. Over time, PH may lead to heart failure. The condition is two to three times more common in women than men.
Henry Ford Health System offers some of the best PH care in the United States. We are one of only two hospitals in Michigan to receive accreditation as a Center of Comprehensive Care — the gold standard for expert PH treatment — from the Pulmonary Hypertension Association (PHA). This recognition means we provide high-level, specialized services that most other hospitals and health systems can’t offer.
Henry Ford’s expertise in pulmonary hypertension
We are one of Michigan’s leaders in diagnosing and treating PH. Our compassionate, collaborative team offers exceptional care, including:
- National accreditation: Fewer than 50 hospitals in the U.S. have earned PHA accreditation as a Center of Comprehensive Care. The rigorous accreditation process ensures that we meet the highest standards of care. Our treatments are based on scientific evidence, and we continually research new options to improve patients’ health. Only the highest quality, most comprehensive centers receive this accreditation.
- Team approach: Our PH team includes critical care-trained pulmonologists (physicians specializing in lung care), a cardiologist (heart specialist), nurse practitioners, nurse coordinators and pharmacists. We discuss all patients as a team and make treatment planning decisions, with your input. You can have confidence that many different specialists are contributing to your well-being. Meet our pulmonary team.
- Pulmonary pharmacists: Our pulmonary pharmacists work closely with PH patients, in and out of the hospital. After a hospitalization, they follow up to be sure you have access to medicines you need. They can also help with copays so you receive your needed medications. And they help manage ongoing medication needs to keep you out of the hospital as much as possible.
- On-site pulmonary testing: Our pulmonary function lab is on the same floor as our PH clinic. You’ll have pulmonary testing at each visit to help us track your condition. Tests like spirometry (blowing into a tube) or the six-minute walk test tell us how your lungs and heart are working. Find out more about pulmonary function tests.
- Dedicated intensive care unit (ICU): Henry Ford Hospital has an ICU section that specializes in treating PH patients. Our specially trained nurses are experts in managing your complex needs. Here, you can receive seamless care from a consistent team of providers. Learn more about pulmonary critical care.
- Research and clinical trials: We help develop and test new medications and treatments for PH. This means you may have the chance to enroll in a clinical trial. These trials offer hope to patients who thought their conditions were not treatable. Learn more about clinical trials.
Symptoms of pulmonary hypertension
The most common PH symptom is difficulty breathing. At first, you might feel short of breath only when you’re exercising. Later, you might have trouble catching your breath more often. As PH worsens, symptoms may limit physical activity. Other symptoms include:
- Chest pain
- Heart palpitations (a racing heart)
- Swelling in the legs and feet
Diagnosing pulmonary hypertension
When your doctor refers you to Henry Ford for specialized PH care, we first confirm the diagnosis. Our doctors do a thorough physical exam, including pulmonary function tests. We review your medical records and check the medications you take.
To better understand your condition, we may order tests. You may take these tests again later in your treatment to measure your progress. Tests often include:
- Heart studies: You may have had an abnormal cardiac ultrasound or two-dimensional (2-D) echocardiogram. These tests study the heart with sound waves. They measure how well your heart can pump and look at the heart’s structures. Depending on your results, we may order other tests to confirm the diagnosis.
- Imaging studies: Several tests help us look inside your lungs, heart and chest. These may include a chest X-ray or computed tomography (CT scan). These tests provide detailed pictures of your chest, its organs and blood vessels.
- Lung ventilation/perfusion scan: A pulmonary ventilation/perfusion scan (VQ scan) measures air and blood flow in your lungs. It helps us rule out a blood clot (pulmonary embolism).
- Right heart catheterization: A right heart catheterization can confirm a PH diagnosis. For this procedure, we insert a catheter (a narrow plastic tube) into the right side of the heart and the pulmonary (lung) artery to check the pressure. We perform catheterization in our cardiac catheterization lab.
- Genetic testing: In some cases, a gene mutation (passed down from family members) increases the risk of PH. We’ll help you identify these risks and discuss them with your family.
Types of pulmonary hypertension
To plan your treatment, we need to know what’s causing the illness. High pressure in the lungs can result from another heart or lung disease or a blood clot. Sometimes, PH develops because of a disease in the vessels themselves.
When vessel disease causes PH, it requires expert treatment. The condition can be life-threatening. When heart or lung disease is the cause, we’ll create a strategy to manage the underlying disease. Careful management can slow the progression of PH.
The World Health Organization (WHO) classifies PH in five groups based on the cause:
- Group 1: Affecting the right heart. This type may occur because of another illness, or it may have no known cause. It may be inherited (passed down from parents in genes). Group 1 disease is also called pulmonary arterial hypertension (PAH).
- Group 2: Occurring because of left heart disease or heart valve disease.
- Group 3: Due to lung diseases and lack of oxygen. Group 3 PH can stem from emphysema and chronic obstructive pulmonary disease (COPD), pulmonary fibrosis or a spine condition called kyphoscoliosis.
- Group 4: Hypertension from chronic blood clots in the lungs (pulmonary embolism).
- Group 5: From causes not listed in these other categories.
Treatment for pulmonary hypertension
We see PH patients frequently, especially in the beginning of care. While the visit schedule depends on your unique treatment plan, we see most patients once every three months. Between visits, we’re available by phone 24 hours a day, seven days a week.
We work to identify possible problems early and prevent your health from deteriorating. We’ll customize a treatment plan including:
- Medications: We have access to medicines that can make PH more manageable, including newly available drugs. Some medications can improve people’s ability to walk and lengthen their lives. Medicines such as digoxin can protect your heart. Blood thinners (anticoagulants) can help you avoid blood clots. We customize a medication regimen to your individual needs. Read more about pulmonary hypertension medicines.
- Preventing fluid retention: Excess fluid in your body can increase pressure on your heart. We’ll teach you to control water intake to avoid swelling and pressure. Water pills (diuretics) can help, too.
- Monitored exercise: Supervised exercise, directed by our respiratory therapists, can help you build stamina, walk more easily and breathe better. Our pulmonary rehabilitation program includes education about your condition. We coordinate your rehabilitation plan with your PH treatment. Find out more about pulmonary rehabilitation.
- Patient education: We answer your questions and provide information about PH at every visit. As needed, we schedule special educational visits for our patients and their families. We also attend support groups led by the Pulmonary Hypertension Association, Detroit Chapter.
- Yoga for pulmonary hypertension: Although conventional yoga can be risky for people with PH, it also has benefits. Focusing on the beneficial poses, we developed a first-of-its-kind yoga exercise program especially for people with PH. The program includes three yoga exercise levels and a nutrition and lifestyle discussion. See the videos on Henry Ford’s YouTube channel, or order DVDs free of charge, by emailing Lisa Ware at [email protected].
Pulmonary hypertension surgery at Henry Ford
Some people with PH need surgical treatment. We offer several surgical options, including:
- Atrial septostomy: This surgical procedure creates a small hole between the right and left sides of the heart. Like a safety valve, it relieves heart pressure. Find out more about our treatments for lung and airway conditions.
- Lung transplantation: For some people, a lung transplant may be the best option. Lung transplantation can help certain people who have advanced interstitial lung disease (ILD) or who don’t respond to advanced therapy with PH medications. Our successful lung transplant program means we offer the full range of treatment options from the same team of doctors you trust. Read more about lung transplant.