Pulmonary hypertension (PH) is a rare condition that affects about 300 people each year in the United States. Because these patients require special care, Birmingham-based CardioVascular Associates P.C. has opened several new clinics, staffed by CVA physicians, which are helping pulmonary hypertension patients manage the disease.

 

Cardiologist Saema Mirza, MD, FACC, and her colleagues Steve Bakir, MD, FACC, and Andrew Miller, MD, FACC, have started the clinics for pulmonary hypertension patients at Trinity Medical Center and Brookwood Medical Center in Birmingham and at clinics in Sylacauga and Talladega. “There was only one clinic for PH patients at UAB, and we wanted to make the services available to the general community because not everyone can use the UAB system,” Mirza says.

 

PH can be dangerous because it causes the blood vessels that supply the lungs to constrict and the walls to thicken, which decreases the amount of blood they can carry. The condition causes a build up of pressure that makes the heart work harder. When the pressure gets high enough, eventually the heart can’t keep up and less blood circulates through the lungs to pick up oxygen. The patient then becomes tired, dizzy and short of breath.

 

“Shortness of breath and fainting spells are the main symptoms of PH which affects mainly middle-aged women. These patients also may report chest pain and swelling in their feet and abdomens related to exertion,” Mirza says. “Because these spells can be the result of a number of conditions, we think the condition is under-diagnosed and under-treated. We want to educate the medical community about PH and make sure physicians know when to refer patients to a PH clinic.”

 

Mirza says that when evaluating patients suspected of having PH, secondary causes like sleep apnea must first be ruled out and treated. Once everything else is ruled out and PH is diagnosed, treatment is begun. Designated clinics are able to provide the specialized care these patients need. “It is difficult for general physicians to treat PH, because patients require regular monitoring and follow up by a cardiologist. We must check the liver regularly and do other tests related to the special medicines the patients must take,” she says.

 

Mirza adds that PH is still a serious disease, but new medicines are now available that can offer patients a better quality of life. “Twenty-five years ago, PH was a rapidly fatal disease with a survival rate of about 2.8 years when no evidence-based therapies were available. The health care community has made tremendous advances in the treatment of this disease, and over the past 10 years we have seen the discovery of new medications that have positively influenced the prognosis and survival of patients with PH,” she says. “Patients taking the medicines require regular monitoring by a cardiologist to ensure the heart continues to function normally.”

 

The Birmingham clinic has a specially trained nurse who works with patients. “Anything they need goes through her first,” Mirza says. “The medicines are expensive and she spends a lot of time working with the insurance companies on behalf of the patients.”

 

Mirza and her colleagues currently see PH patients in the general cardiology clinics. “Once we have enough patients, we will pool them into special PH clinics where they will be set apart from other cardiology patients,” she says.