One of the causes of pulmonary hypertension is poor quality breathing during sleep. If someone’s oxygen levels are low during sleep, this condition puts a lot of strain on the lungs and heart and may lead to pulmonary hypertension. Since a patient would be asleep when these abnormalities of breathing are occurring, she/he may not feel that their breathing is limited during sleep and may not be aware of this.
- A sleep study is a study done in a sleep center (which is typically not a hospital). The patients come to the sleep center in the evening, get hooked up to different monitors including an oxygen monitor and are asked to sleep (most patients’ first reaction is that they won’t be able to sleep in a “strange environment” other than their own bed, & hooked up to different monitors. But most patients end up sleeping enough to give us the data needed). When they wake up in the morning, they go back home. If a patient indeed has trouble with her/his breathing when asleep, they may need to be on oxygen or use certain masks, such as a CPAP (continuous positive airway pressure), at night to help with their breathing and to improve their pulmonary hypertension.
- An overnight oximetry study is a test in which a recording “pulse oximeter monitor” (a small non-invasive machine with a probe that is taped to the finger) continuously measures a patient’s oxygen level and heart rate overnight. This test could be done in someone’s home. This is more convenient than the sleep study but does not give us all the information needed.
An EKG is a non-invasive test that measures the electricity of the heart. It involves placing what is called ‘leads’ on the chest, arms, and legs. The patient does not feel any electricity or discomfort during this test. The EKG provides information about how fast and regular the heart is beating and gives us a general sense about the global function of the different parts of the heart, which in turn need to be confirmed by an echocardiogram.
The echocardiogram (sometimes referred to as the “echo“) is a non-invasive ultrasound test of the heart that does not involve any radiation. It is very safe to have echocardiograms. The ultrasound technician would be using gel (which may sometimes feel cold) on an ultrasound probe that is connected to the ultrasound machine. That machine has a screen similar to a desktop computer screen. Multiple images are recorded during this test.
The echo test is extremely important because it gives us a general idea about the size and function and interaction of the different heart chambers. It can also assess the function of the different heart valves. An echocardiogram is done on every patient who is suspected to have pulmonary hypertension, and then on a regular basis after the diagnosis is made.
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