Pulmonary Vascular Disease
Symptoms of Pulmonary Vascular Disease continued...
Although symptoms of pulmonary vascular disease can vary widely, each of the causes of pulmonary vascular disease has a set of usual symptoms:
Pulmonary arterial hypertension: This most often causes slowly progressive shortness of breath. As the condition worsens, chest pain or fainting (syncope) with exertion can occur.
Pulmonary embolism: A blood clot to the lungs typically occurs suddenly. Shortness of breath, chest pain (often worse with deep breaths), and a rapid heart rate are common symptoms. Pulmonary embolism symptoms range from barely noticeable to severe, based on the size of the blood clot(s).
Pulmonary venous hypertension: This form of pulmonary vascular disease also causes shortness of breath, due to the congestive heart failure that's usually present. Shortness of breath may be worse while lying flat, when blood pressure is uncontrolled, or when extra fluid is present (edema).
Tests for Pulmonary Vascular Disease
Based on a person's symptoms, signs, and story, a doctor may begin to suspect the presence of pulmonary vascular disease. The diagnosis of pulmonary vascular disease is usually made using one or more of the following tests:
Computed tomography (CT scan): A CT scanner takes multiple X-rays, and a computer constructs detailed images of the lungs and chest. CT scanning can usually detect a pulmonary embolism in a pulmonary artery. CT scans can also uncover problems affecting the lungs themselves.
Ventilation/perfusion scan (V/Q scan): This nuclear medicine test takes images of how well the lungs fill with air. Those images are compared to pictures of how well blood flows through the pulmonary blood vessels. Unmatched areas may suggest a pulmonary embolism (blood clot) is present.
Echocardiography (echocardiogram): An ultrasound video of the beating heart. Congestive heart failure, heart valve disease, and other conditions contributing to pulmonary vascular disease can be discovered with echocardiogram.
Right heart catheterization: A pressure sensor is inserted through a needle into a vein in the neck or groin. A doctor advances the sensor through the veins, into the right heart, then into the pulmonary artery. Right heart catheterization is the best test to diagnose pulmonary arterial hypertension.
Chest X-ray film: A simple chest X-ray can't diagnose pulmonary vascular disease. However, it may identify contributing lung disease, or show enlarged pulmonary arteries that suggest pulmonary arterial hypertension.
Pulmonary angiography (angiogram): Contrast dye is injected into the blood, and X-ray images of the chest show detailed images of the pulmonary arterial system. Angiography is very good at diagnosing pulmonary embolism but is rarely performed anymore because CT scans are easier, less invasive, and have lower risk.
Treatments for Pulmonary Vascular Disease
There are many different treatments for pulmonary vascular disease. Pulmonary vascular disease is treated according to its cause.
Pulmonary embolism: Blood clots to the lungs are treated with blood thinners (anticoagulation). The most often used medicines are heparin, enoxaparin (Lovenox) and warfarin (Coumadin).