Heart Programs - University of Minnesota Physicians Heart at Fairview

Pulmonary Hypertension

Pulmonary Hypertension (PH) program provides comprehensive and innovative care for people diagnosed with PH through a multidisciplinary team focused on improving patient outcomes. The goals of the PH program are to:

  • relieve symptoms of the disease;
  • improve perceived quality of life and increase longevity.

University of Minnesota Physicians Heart offers a dedicated team—two cardiologists, two nurse practitioners and a nurse—who concentrate exclusively on pulmonary hypertension. Based at the University of Minnesota Medical Center, Fairview, this multidisciplinary team works to diagnose pulmonary hypertension and help you manage your care.

Our program cares for you in a three-way partnership -- you, our specialists and your primary care physician work together to find the best solutions to your PH. Wherever you live in the Upper Midwest, you and your community physician have ongoing, personal access to the pulmonary hypertension team and all university resources.

What is Pulmonary Hypertension?
Pulmonary Hypertension is a complex and challenging disease that demands diligent management. It is a disease that damages the arteries of the lungs. By simple definition, it is high blood pressure in the lungs, and is not simple to diagnose. A complex and chronic illness, PH is relatively rare.

Under normal conditions, the blood pressure in the lungs is low and blood flows easily through the vessels. Sometimes the blood vessels in the lungs become narrow, scarred, or blocked. This causes the pressure in the vessel to increase, resulting in PH. When PH is present, the right side of the heart has to work harder to get blood through the narrowed vessels to the lungs. With time, the right heart can grow larger and weaken, therefore not being able to pump as well. This can eventually result in heart failure.

Confirming the diagnosis
Pulmonary hypertension is often not diagnosed in a timely manner because its early symptoms can be confused with many other conditions.

If, in the process of diagnosis, you first see your primary care physician, you will likely have a physical exam, blood tests, chest X-ray and electrocardiogram. All that information is valuable. Both the chest X-ray and electrocardiogram may show evidence of enlargement of the right side of your heart. Additionally, the echocardiogram can help estimate the blood pressure in your lungs.

Our cardiologists make the preliminary diagnosis for PH with echocardiography. This form of ultrasound detects and measures blood flow, measures pulmonary blood pressure and assesses what damage has occurred in the right ventricle of the heart. Echocardiography is painless and noninvasive.

A PH diagnosis is always confirmed with right-heart catheterization. One of our cardiologists will thread a catheter (long, thin, flexible tube) into your blood vessels. Tiny built-in sensors on the catheter measure the pressures and blood flow through the right heart chambers and lungs. The catheterization gauges how much blood your heart is pumping. The catheter is usually inserted through a vein in your neck or groin.

Medical management
If you have PH, we will try to find the cause. The cause can help direct the most specific treatment. Our team has expertise, years of experience in clinical research and patient care, and the passion to educate and support you, as we help you manage the therapy most appropriate for your condition.

Medical management is the treatment for PH. There is no cure for PH, but available treatments can help lessen symptoms and improve your quality of life. When PH is the result of another condition, University of Minnesota Physicians will also treat the underlying cause whenever possible.

Treatment may include a range of oral or inhaled medications, such as:

  • Prostanoids (Flolan, Remodulin, iloprost)—widen the arteries and reduce high blood pressure in the lungs
  • Coumadin (warfarin)—treats and prevents blood clots in the lungs
  • Viagra or Revatio (sildenafil)—opens the arteries to reduce pressure in the lungs
  • Tracleer or Letairis (endothelin receptor antagonists)—widens narrow vessels and improves your ability to exercise
  • Diuretics (water pills)—reduce extra body fluid
  • Oxygen—helps if you have sleep apnea

In a small number of cases, lung transplantation is a treatment for this disease.

Complimentary care is provided through coordination of assets within various departments, including Pulmonology, Rheumatology, Sleep Medicine, Hepatology, and Hematology. The Cardiovascular Center works in conjunction with the Thoracic Transplant Center to meet the needs of those PH patients awaiting lung transplantation.

Research also plays a critical role in advancing PH treatment as well as improving quality of life for patients. University of Minnesota Physicians is involved in large pharmaceutical industry-sponsored trials of new agents, and we work independently at testing unique compounds that exist for other indications and apply them to patients with pulmonary hypertension. Our commitment to innovative patient care and clinical trials is at the heart of our program.

Open dialogue and research
The PH team at the University of Minnesota Medical Center, Fairview works closely with the University’s lung program, both for transplants and to help patients whose pulmonary hypertension may be complicated by pulmonary fibrosis, emphysema or chronic obstructive pulmonary disease. Likewise, PH specialists collaborate with the university’s liver transplant program, given that pulmonary arterial hypertension is a complication of advanced liver disease. Integrated care is a hallmark of academic medicine and Fairview.

Dialogue between health care providers, people affected with PH and their significant others, is encouraged. Twenty-four hour telephone support provides for consistently availability and maintained communication.

Make an appointment
Our PH team sees patients at the University of Minnesota Medical Center, Fairview as a part of University of Minnesota Physicians Heart. Referrals may be initiated by patients, primary care physicians, or other specialty care physicians. Our team believes that communication is key to success, and strives to communicate with referring providers on a frequent basis. Additionally, we work very closely as a team and hold weekly meetings to discuss outstanding patient issues or challenging cases.