What is pulmonary hypertension, and how is it linked to heart failure?
Learn more from Dr. Sula Mazimba, a UVA specialist in pulmonary hypertension.
Selected Podcast
Treating Pulmonary Hypertension
Featured Speaker:
Sula Mazimba, MD
Dr. Sula Mazimba is board certified in internal medicine and cardiovascular disease and specializes in caring for patients with pulmonary hypertension and heart failure. Transcription:
Treating Pulmonary Hypertension
Melanie Cole (Host): What is pulmonary hypertension and how is it linked to heart failure? My guest today is Dr. Sula Mazimba. He is board certified in internal medicine and cardiovascular disease and he specializes in caring for patients with pulmonary hypertension and heart failure. Welcome to the show, Dr. Mazimba. Tell us a little bit about pulmonary hypertension. What is it and how does it differ from hypertension that we might have heard about?
Dr. Sula Mazimba (Guest): Thank you so much for having me on the show. Pulmonary hypertension is a type of blood pressure that affects the arteries in the lungs and ultimately the right side of the heart. In order to be able to sort of understand the disease, it’s important to understand that we have two sides of the heart, the circulation. There is the left side and the right side. In order for blood to pump around the body, it has to pump from the left side which has a higher pressure to the rest of the body and ultimately to the right side which takes blood to the lungs. The right side of the heart has fairly low pressure. It’s a low pressure system. In some situations where you start having elevation in blood pressure in their right side of the heart or the lungs, what happens is that the circulation is impaired, meaning that the blood going to the lungs is not able to adequately get oxygenated, and so it affects the circulation around the heart. That’s kind of, in a nutshell, what pulmonary hypertension really is.
Melanie: What symptoms might somebody experience if they think that they might have this?
Dr. Mazimba: The symptoms for pulmonary hypertension are actually very nonspecific, and because of this, sometimes patients present very late. Typical symptoms include shortness of breath, which as you know is very nonspecific. Patients really just feel short of breath and very tired, dizzy, occasionally they may have some chest pains or racing heart, and so they tend to be very nonspecific.
Melanie: Okay, so what would send somebody in to see you to even get tested for pulmonary hypertension? Would it have anything to do with if they have been suffering from regular hypertension before or if they have a family history of this situation?
Dr. Mazimba: In some cases, patients do have family history of pulmonary hypertension, and sometimes they come testing for the disease, but those are very few situations. Oftentimes, patients who have presented at their primary care physician, they may have been trying to find out why they are very short of breath and very tired. Ultimately, an echocardiogram is ordered and that kind of shows that the pressures on the right side of the heart are high and that’s how they end up oftentimes coming to see us.
Melanie: If you diagnosed someone with pulmonary hypertension, then what do you do for them?
Dr. Mazimba: Well, in some cases, pulmonary hypertension is related to other disease conditions, and so when we are treating pulmonary hypertension, we often treat also the underlying disease condition. The treatments are often very complex. The medications, they are sometimes very complex, and so we oftentimes have to make combination therapies. There are also what we call supportive therapies, where we essentially, not necessarily, altering the disease process, but we are kind of helping patients deal with the symptoms, like for instance, giving them some diuretics, oxygen, blood thinners. In some situations, we resort to surgery. We may have to sometimes recommend lung transplant or heart and lung transplant, depending on the situation.
Melanie: What are some of the complications that could happen if… they can go into heart failure if this isn’t treated? How long can it go on before those complications might start to set in?
Dr. Mazimba: That’s a very good question. Pulmonary hypertension is, like I said, associated with other disease conditions, and so it depends on the company it keeps. There are some situations where, for instance, it may be connected with rheumatoid arthritis or other connective tissue disease, and so depending on the company it keeps, the prognosis also varies according to the type of pulmonary hypertension. There are various types. We often categorize pulmonary hypertension in five major groups. Each of those groups may have different prognostic type over the long haul. In general, without treatment, pulmonary hypertension can be very fatal and so this is why it’s critically important for patients to present early so that we can institute some of these medical advances including therapy treatments and sometimes surgeries.
Melanie: Dr. Mazimba, how does your expertise in hypertension relate to your work with heart failure patients?
Dr. Mazimba: As you know, when pulmonary hypertension is severe enough, it impairs the contractility of the right ventricle, meaning that the right ventricle will have to struggle to push blood to the lungs. Ultimately, heart failure is the leading cause of death in patients with severe pulmonary hypertension. There is that link between pulmonary hypertension and advanced heart failure.
Melanie: Wow, it’s really very interesting. Tell the listeners why should someone come to UVA for heart failure and pulmonary hypertension care and give your best advice for people that might be suffering some of these nonspecific symptoms and what you would tell them.
Dr. Mazimba: One of the reasons why patients should really look at UVA as a place where they need to seek their care is that pulmonary hypertension and heart failure are very complex disease conditions, especially heart failure when it’s advanced. They are best served in medical teams that specialize in these disorders. At UVA, we see patients from within the state and outside the state. We have a lot of experience when we’re talking about pulmonary hypertension and advanced heart failure. That is one of the strong points, advantages of care at UVA. It’s multidisciplinary and we see a lot of very complex patients. One of the things I advise patients who are having these nonspecific symptoms is, of course, talk to your doctor about this and don’t blow away the symptoms and say, “Well, it’s maybe I’m just tired.” Indeed, you may be tired, but if the symptoms persist, it’s important to seek medical advice.
Melanie: That’s very good information. You are listening to UVA Health Systems Radio. For more information, you can go to uvahealth.com. That’s uvahealth.com. This is Melanie Cole. Thanks so much for listening.
Treating Pulmonary Hypertension
Melanie Cole (Host): What is pulmonary hypertension and how is it linked to heart failure? My guest today is Dr. Sula Mazimba. He is board certified in internal medicine and cardiovascular disease and he specializes in caring for patients with pulmonary hypertension and heart failure. Welcome to the show, Dr. Mazimba. Tell us a little bit about pulmonary hypertension. What is it and how does it differ from hypertension that we might have heard about?
Dr. Sula Mazimba (Guest): Thank you so much for having me on the show. Pulmonary hypertension is a type of blood pressure that affects the arteries in the lungs and ultimately the right side of the heart. In order to be able to sort of understand the disease, it’s important to understand that we have two sides of the heart, the circulation. There is the left side and the right side. In order for blood to pump around the body, it has to pump from the left side which has a higher pressure to the rest of the body and ultimately to the right side which takes blood to the lungs. The right side of the heart has fairly low pressure. It’s a low pressure system. In some situations where you start having elevation in blood pressure in their right side of the heart or the lungs, what happens is that the circulation is impaired, meaning that the blood going to the lungs is not able to adequately get oxygenated, and so it affects the circulation around the heart. That’s kind of, in a nutshell, what pulmonary hypertension really is.
Melanie: What symptoms might somebody experience if they think that they might have this?
Dr. Mazimba: The symptoms for pulmonary hypertension are actually very nonspecific, and because of this, sometimes patients present very late. Typical symptoms include shortness of breath, which as you know is very nonspecific. Patients really just feel short of breath and very tired, dizzy, occasionally they may have some chest pains or racing heart, and so they tend to be very nonspecific.
Melanie: Okay, so what would send somebody in to see you to even get tested for pulmonary hypertension? Would it have anything to do with if they have been suffering from regular hypertension before or if they have a family history of this situation?
Dr. Mazimba: In some cases, patients do have family history of pulmonary hypertension, and sometimes they come testing for the disease, but those are very few situations. Oftentimes, patients who have presented at their primary care physician, they may have been trying to find out why they are very short of breath and very tired. Ultimately, an echocardiogram is ordered and that kind of shows that the pressures on the right side of the heart are high and that’s how they end up oftentimes coming to see us.
Melanie: If you diagnosed someone with pulmonary hypertension, then what do you do for them?
Dr. Mazimba: Well, in some cases, pulmonary hypertension is related to other disease conditions, and so when we are treating pulmonary hypertension, we often treat also the underlying disease condition. The treatments are often very complex. The medications, they are sometimes very complex, and so we oftentimes have to make combination therapies. There are also what we call supportive therapies, where we essentially, not necessarily, altering the disease process, but we are kind of helping patients deal with the symptoms, like for instance, giving them some diuretics, oxygen, blood thinners. In some situations, we resort to surgery. We may have to sometimes recommend lung transplant or heart and lung transplant, depending on the situation.
Melanie: What are some of the complications that could happen if… they can go into heart failure if this isn’t treated? How long can it go on before those complications might start to set in?
Dr. Mazimba: That’s a very good question. Pulmonary hypertension is, like I said, associated with other disease conditions, and so it depends on the company it keeps. There are some situations where, for instance, it may be connected with rheumatoid arthritis or other connective tissue disease, and so depending on the company it keeps, the prognosis also varies according to the type of pulmonary hypertension. There are various types. We often categorize pulmonary hypertension in five major groups. Each of those groups may have different prognostic type over the long haul. In general, without treatment, pulmonary hypertension can be very fatal and so this is why it’s critically important for patients to present early so that we can institute some of these medical advances including therapy treatments and sometimes surgeries.
Melanie: Dr. Mazimba, how does your expertise in hypertension relate to your work with heart failure patients?
Dr. Mazimba: As you know, when pulmonary hypertension is severe enough, it impairs the contractility of the right ventricle, meaning that the right ventricle will have to struggle to push blood to the lungs. Ultimately, heart failure is the leading cause of death in patients with severe pulmonary hypertension. There is that link between pulmonary hypertension and advanced heart failure.
Melanie: Wow, it’s really very interesting. Tell the listeners why should someone come to UVA for heart failure and pulmonary hypertension care and give your best advice for people that might be suffering some of these nonspecific symptoms and what you would tell them.
Dr. Mazimba: One of the reasons why patients should really look at UVA as a place where they need to seek their care is that pulmonary hypertension and heart failure are very complex disease conditions, especially heart failure when it’s advanced. They are best served in medical teams that specialize in these disorders. At UVA, we see patients from within the state and outside the state. We have a lot of experience when we’re talking about pulmonary hypertension and advanced heart failure. That is one of the strong points, advantages of care at UVA. It’s multidisciplinary and we see a lot of very complex patients. One of the things I advise patients who are having these nonspecific symptoms is, of course, talk to your doctor about this and don’t blow away the symptoms and say, “Well, it’s maybe I’m just tired.” Indeed, you may be tired, but if the symptoms persist, it’s important to seek medical advice.
Melanie: That’s very good information. You are listening to UVA Health Systems Radio. For more information, you can go to uvahealth.com. That’s uvahealth.com. This is Melanie Cole. Thanks so much for listening.