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Cardiolucent

Condition

Pulmonary Hypertension

Elevated lung-artery pressure that strains the right heart, evaluated with echocardiography.

Pulmonary hypertension is high blood pressure within the arteries that carry blood from the heart to the lungs. Unlike systemic hypertension, which strains the left ventricle, pulmonary hypertension forces the right side of the heart to work against elevated resistance, and over time this can lead to right heart failure. There are several distinct categories of pulmonary hypertension, with different causes and different treatments — ranging from left heart disease and lung disease to clot-related and primary pulmonary arterial hypertension. Identifying the type is essential because therapies vary dramatically. Dr. Kedan evaluates pulmonary hypertension as a distinct entity from systemic hypertension and coordinates with pulmonary hypertension specialists at Cedars-Sinai when advanced therapy is required.

What Cardiolucent Evaluates

  • Symptom history focused on exertional dyspnea, syncope, and exercise intolerance
  • Echocardiography with right ventricular assessment and estimated pulmonary pressures
  • POCUS at every visit for interval reassessment
  • EKG and chest imaging to screen for lung and structural causes
  • Sleep apnea screening when clinically appropriate
  • Coordination with pulmonary medicine, rheumatology, and pulmonary hypertension specialists at Cedars-Sinai
  • Right heart catheterization referral when confirmation or hemodynamic classification is needed

Common Symptoms

  • Shortness of breath with exertion that progressively worsens
  • Fatigue and reduced exercise capacity
  • Lightheadedness or fainting, especially with activity
  • Chest pressure or palpitations
  • Swelling of the legs or abdomen in advanced disease
  • Symptoms often subtle and progressive over months or years

Risk Factors

  • Left-sided heart disease (heart failure or valve disease)
  • Chronic lung disease such as COPD or interstitial lung disease
  • Obstructive sleep apnea
  • Prior pulmonary embolism (chronic thromboembolic pulmonary hypertension)
  • Connective tissue disease, especially scleroderma
  • HIV infection, certain liver diseases, and certain congenital heart conditions
  • Family history of pulmonary arterial hypertension
  • Certain medications and toxins

How Cardiolucent Approaches Treatment

Treatment depends entirely on the underlying class of pulmonary hypertension. For the most common form related to left heart disease, the focus is optimizing heart failure and valve management. Lung-related pulmonary hypertension responds to addressing the lung disease and sleep apnea, while chronic thromboembolic disease may be curable with surgery. Pulmonary arterial hypertension requires specialized vasodilator therapies prescribed in expert centers. Dr. Kedan defines the category, manages cardiovascular contributors directly, and coordinates with pulmonary hypertension specialists when targeted therapy is indicated.

Common Questions

Frequently Asked Questions

What is pulmonary hypertension?
Pulmonary hypertension is sustained elevation of pressure in the arteries leading from the heart to the lungs. Over time this strains the right ventricle and reduces the heart's ability to deliver oxygenated blood efficiently.
How is pulmonary hypertension related to regular hypertension?
Pulmonary hypertension is a distinct condition from systemic hypertension. Systemic hypertension is elevated pressure in the arteries leaving the left heart to the body, while pulmonary hypertension is elevated pressure in the arteries leaving the right heart to the lungs. The two have very different causes, diagnostic approaches, and treatments.
What are the different types of pulmonary hypertension?
There are five WHO groups, the most common being pulmonary hypertension due to left heart disease (Group 2). Other groups include pulmonary arterial hypertension (Group 1), lung disease-related (Group 3), chronic thromboembolic (Group 4), and miscellaneous causes (Group 5). Identifying the group is essential because treatment differs sharply.
How is it diagnosed?
Echocardiography is the first-line screening test and provides an estimated pulmonary artery pressure as well as right heart structure and function. Definitive confirmation and classification typically require right heart catheterization, performed in coordination with pulmonary hypertension specialists. Additional testing — sleep study, lung function tests, ventilation/perfusion scan — helps identify the underlying cause.
What symptoms suggest pulmonary hypertension?
Progressive shortness of breath with exertion is the hallmark symptom, often dismissed as deconditioning. Fatigue, near-fainting, palpitations, and leg swelling in advanced cases are also typical. Because symptoms are nonspecific, the diagnosis often comes late, which is why prompt evaluation in higher-risk patients matters.
Is pulmonary hypertension dangerous?
Pulmonary hypertension can be serious, particularly when severe or related to pulmonary arterial hypertension or chronic thromboembolic disease. Many milder forms — particularly those related to left heart disease — improve substantially when the underlying problem is addressed. Outcomes have improved dramatically with modern targeted therapies for the more severe forms.
How is it treated?
Treatment is tailored to the type. Left-heart-related pulmonary hypertension is treated by optimizing heart failure and valve disease. Lung-related disease focuses on the underlying lung condition and sleep apnea. Pulmonary arterial hypertension is treated with specialized vasodilator medications. Chronic thromboembolic disease may be treated surgically with pulmonary endarterectomy.
Can lifestyle help?
Lifestyle measures support every form: maintaining a healthy weight, treating sleep apnea, supervised exercise within safe limits, and avoiding medications and supplements that worsen the condition. Vaccinations against influenza and pneumonia are particularly important.
Do I need a specialist referral?
Many patients are managed effectively by a cardiologist when the cause is well defined. Pulmonary arterial hypertension and chronic thromboembolic disease should be managed in coordination with a recognized pulmonary hypertension center, and Dr. Kedan refers to Cedars-Sinai when that level of expertise is needed.
How do I schedule a consultation?
Call (310) 304-5555 or use the contact form to schedule with Dr. Kedan at the Beverly Hills office. Cardiolucent does not bill Medicare or insurance; a detailed superbill is provided for any out-of-network reimbursement.

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The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.