DEAR DR. DONOHUE: I am a 43-year-old woman and the mother of two young children. I have just been told I have pulmonary hypertension. According to my doctors, this has nothing to do with high blood pressure, which I do not have. This confuses me. I am slightly short of breath when I have to climb stairs from our basement to the second floor, but aside from that I feel OK. What is this thing? – P.G.

ANSWER:
Pulmonary hypertension is high blood pressure in the lungs’ blood vessels. It doesn’t have anything to do with body pressure. The lungs are delicate structures, and they can’t tolerate the pressure needed in the body’s circulation to propel blood to all tissues and organs. Lung blood pressure is only one-fifth the pressure of body blood pressure.

Emphysema and chronic bronchitis can raise lung blood pressure. At your age, you’re not likely to have either. Scleroderma, an illness that turns the skin hard, is another cause. Heart-valve problems can bring it on. Sometimes, it runs in families. Quite often, no cause is found and then it is called idiopathic (a word whose meaning is “no known cause”) pulmonary arterial hypertension.

The fact that you are young makes the outlook for you more favorable. You don’t have pronounced symptoms, another favorable factor. With advanced pulmonary hypertension, people become breathless during slight activity. They have no energy to perform the usual, daily tasks. Frequently, they have chest pain when they’re doing anything requiring exertion. Sometimes, the ankles and feet swell, and affected people are prone to fainting.

If your lung blood pressure has risen because of some other illness, treatment is directed to that illness. For idiopathic pulmonary hypertension, there are medicines now available that were not available a decade ago. One is epoprostenol, administered intravenously through a small portable pump. Sildenafil – the medicine originally marketed for erectile dysfunction – is another treatment. For resistant pulmonary hypertension, lung transplant is an option.

DEAR DR. DONOHUE: My husband is 78. Ten years ago, he had a liver transplant. He has lab work done every month, and the results are always good.

He just had a hernia repaired, and the operative report states “advanced liver cirrhosis.”

The surgeon refuses to discuss this with me or my husband. Can anything be done in this situation? – M.I.

ANSWER:
Was your husband’s hernia an inguinal hernia, the common groin hernia? A surgeon who repairs that kind of hernia doesn’t get a look at the liver. I have no idea how your husband’s surgeon came up with this diagnosis, unless he was referring to your husband’s natural liver, the liver that was removed.

I don’t understand why this doctor won’t speak to you. The mention that your husband’s liver has cirrhosis is probably a choice of poor wording, but you both need assurance about that.

To what doctor do your husband’s monthly lab reports go? Call that doctor and tell him what the operative report says. I’ll bet he’ll be able to get the surgeon to explain what he wrote.

DEAR DR. DONOHUE: For several years, I have experienced chest pain. Numerous cardiac tests reveal that nothing is wrong with me or my heart. I drink alcohol, probably more than what’s considered moderation.

Is there a correlation between alcohol consumption and heart disease? – A.C.

ANSWER:
Excessive amounts of alcohol can lead to alcoholic cardiomyopathy. Cardiomyopathy is a heart condition in which the heart muscle becomes so feeble that it can’t generate enough power to propel blood through the body. Binge drinking can bring on abnormal heart rhythms. Both of these ailments should have been discovered by the tests you had taken.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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