Pulmonary heart disease program

Advocate Health Care has one of the largest pulmonary heart disease (PHD) programs in the region. Our team brings together cardiologists, pulmonologists, advanced practice clinicians and nurses. Everyone on the team has special training in diagnosing and treating pulmonary heart disease.

All of that means you have access to the latest treatments and better outcomes, including those developed through our research and clinical trials. Our coordinated, multidisciplinary approach allows our specialists to stay up to date on the latest medications and therapies.

What is pulmonary heart disease?

Pulmonary heart disease is a rare condition where the heart cannot pump enough blood to the body. It usually begins with pulmonary hypertension, or high blood pressure in the arteries inside the lungs. Pulmonary hypertension is a condition that specifically affects the arteries in the lungs. It’s different from hypertension in other parts of the body.

Without enough blood flowing through arteries in the lungs, the heart has to work harder to pump blood. This effort causes the heart muscles to expand and weaken. Eventually, it can lead to pulmonary heart failure.

What causes pulmonary hypertension and pulmonary heart disease?

There are several things that can cause PHD. Doctors divide these underlying causes into five groups:

• Group 1: PHD caused by pulmonary arterial hypertension (PAH). PAH causes small arteries in the lungs to narrow and increases pressure in the lungs. Pulmonary arterial hypertension could be genetic or result from other diseases, such as liver disease or HIV. In some situations, PAH is idiopathic, meaning there is no clear cause.
• Group 2: PHD caused by heart disease. Narrowing arteries in the lungs don’t cause this condition. Instead, it’s the result of heart disease where the heart cannot pump enough blood from the lungs out to the body. Blood “backs up” inside the heart and raises the pressure in the lungs.
• Group 3: PHD caused by lung disease. The most common lung diseases that lead to PHD are sleep apnea, emphysema and chronic obstructive pulmonary disease (COPD). Certain lifestyle choices can increase these risk factors, including smoking and obesity.
• Group 4: PHD caused by CTEPH. Chronic thromboembolic pulmonary hypertension (CTEPH) occurs when a blood clot forms in the lungs and the body cannot dissolve it. The blood clot increases pressure inside the lungs and the heart must work harder to pump blood.
• Group 5: PHD caused by unknown reasons. Certain conditions can increase the risk of pulmonary heart disease. These conditions include sickle cell anemia, sarcoidosis, chronic hemolytic anemia and other metabolic disorders. Doctors do not understand exactly how they affect PHD.

Previously, there were few treatment options for pulmonary heart disease. Today, people can get the treatment they need to slow disease progression and improve their quality of life.

Symptoms of pulmonary heart disease

Pulmonary heart disease is difficult to diagnose because there are so many potential causes. The symptoms are often similar to other heart and lung conditions and include:

• Bloating
• Kidney or liver failure
• Leg swelling (edema)
• Lightheadedness or feeling like you are about to pass out (syncope)
• Low oxygen levels
• Right-side heart failure
• Shortness of breath

Pulmonary heart disease treatment at Advocate Heart Institute

At Advocate Heart Institute we have all the diagnostic tools to identify what is causing pulmonary heart disease. With that information, we can develop an individualized treatment plan to address the underlying cause and heart damage using:

Coordinated, multispecialty care

One of the most important aspects of effective PHD treatment is coordinating care with both a pulmonologist and a cardiologist. Patients in the pulmonary heart disease program meet with both specialists, often at the same time, to discuss treatment options.

Nurse practitioners on the team also monitor patients carefully to manage treatments and medications. Our nurse practitioners will:

• Contact patients regularly to discuss dosage and side effects and answer any questions
• Gradually increase dosage while managing side effects so each patient gets the maximum tolerated dose for the best outcome
• Help patients understand how and when to take medications

By staying in touch with patients, we can ensure the right medication and treatment regimen. This regular communication throughout treatment provides better outcomes.

Advanced tools to diagnose and treat PHD

The specialists at Advocate Heart Institute have access to all the tools, technologies and treatment options for PHD. We can accurately diagnose the underlying cause of pulmonary heart disease.

We also work closely with specialists outside cardiology and pulmonology to coordinate treatment for other conditions as needed. This extensive access to specialists and treatments ensures that all pulmonary heart disease patients get the best care. Many of our patients benefit from seeing interventional pulmonology specialists that offer leading-edge procedures.

Access to specialized medications and drug therapies

Many of the medicines to treat pulmonary heart disease are very new and highly specialized. These drugs are not available everywhere, and not every doctor has the right experience to prescribe and monitor PHD medications.

Our pulmonary heart disease team has access to all these medications. We also have experience prescribing the right combination of drugs and the proper dosage for:

• Inhaled medications
• Intravenous fluid (IV) medications
• Oral medications
• Subcutaneous (injected under the skin) medications