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Tuesday, March 11, 2014
Do I have Pulmonary Hypertension?
Good Day, I have been diagnosed with Severe Stage 111 COPD. I recently had a routine chest x-ray that showed a soft tissue nodule in the right upper lope. After numerous tests this turned out to be non small cell lung cancer. My doctors were very concerned with operating as my lung function test and others did not look good. One of the tests showed that I had high pulmonary blood pressure 60% on the left and 40% on the right. I decided to take a chance and I had a wedge resection to remove the tumor. The operation was a complete success and (hopefully) they got all the cancer. I am now left with a concern that has not been addressed and that is with regards to the High Pulmonary Blood Pressure. Is this a concern that should be followed up and if so with which doctor? Could you please explain what the High Pulmonary Blood Pressure 60% on the left and 40% on the right means and what problems this could cause? Do I have Pulmonary Hypertension?
Thank you so much for your time and efforts.
Thank you for your question. It is difficult to answer your question without knowing exactly what testing has been done; however, I can make a few general comments and speculate a little on the rest.
In general, there is no significant difference between the blood pressure in the left lung and the right lung. My suspicion is that you had something called a perfusion scan before your lung surgery. It likely indicated that 60% of the total blood flow was to the left lung and 40% was to the right lung. This study helps your doctors determine if you will have enough lung function to do well after the lung resection. It does not diagnose pulmonary hypertension.
In general, pulmonary hypertension is initially suspected based on the results of an echocardiogram (heart ultrasound test) and the diagnosis is then actually made based on the results of a right heart catheterization (also called pulmonary artery catheterization).
Some patients with COPD will develop pulmonary hypertension as a result of this lung disease. Most of the time the pulmonary hypertension is mild and we do not recommend specific treatment for the pulmonary hypertension. However, a small group of patients with COPD will have severe pulmonary hypertension, and in this select group of patients we will often try to treat this condition with medications.
Douglas W Haden, MD
College of Medicine
The Ohio State University