Pulmonary Hypertension masquerading as bronchial asthma or complicating asthma

At times the symptoms of Pulmonary Hypertension can be confused with those of asthma. The symptoms of Pulmonary Hypertension include breathlessness most common symptom), shortness of breath on exertion, cardiac palpitations, fatigue, faintness and chest discomfort. Findings upon examination may include lower extremity swelling (edema) and prominent neck (jugular) veins. Although chest x-ray, CT scan of the chest, and echocardiograms can help diagnosis pulmonary hypertension, right heart catheterization is the study of choice in establishing the diagnosis.

Most individuals with pulmonary hypertension do not have pulmonary function test results typical of asthmatic individuals who demonstrate clear signs of obstruction. Also individuals with pulmonary hypertension may show evidence of a decrease in oxygen levels on exertion, which is rarely seen in non acute asthmatic individuals. The diagnosis of pulmonary hypertension may be difficult because both asthma and pulmonary hypertension may coexist in the same individual. This coexistence may explain a worsening of respiratory symptoms in an asthmatic individual receiving comprehensive asthma treatment.

There are many type of pulmonary hypertension including:

1. Pulmonary arterial hypertension or idiopathic (unknown cause) pulmonary
    hypertension found mostly in young and middle aged women;

2. Pulmonary hypertension associated with left heart disease (heart failure,
    mitral stenosis);

3. Pulmonary hypertension due to chronic obstructive pulmonary disease
    (COPD) or hypoxemia (low oxygen);

4. Pulmonary hypertension due to thromboembolic disease (blood clots);

5. Pulmonary hypertension due to sarcoidosis, fibrosing mediastinitis, fibrosis of
    the lungs, etc.

Treatment depends on the type of pulmonary hypertension and this disease process is usually managed by a pulmonologist.