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Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 6664
Experience:  MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Is an enlarged pulmonary artery something abnormal? I've

Resolved Question:

Is an enlarged pulmonary artery something abnormal? I've been experiencing hortness of breathe, dyspnea upon exercising, high bpm, and a light headed feeling during a light workout. My doctor thinks I might have pulmonary hypertension because my pulmonary artery is enlarged, according to my chest xray, ct scan and ultrasound. What are the chances of me having PH?
Submitted: 7 years ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 7 years ago.
Hi,
Im sorry to hear about your symptoms,

Can you tell me have you had an Echo (this you mean an echo when you said an ultrasound?) what did it show?
Any history of smoking or exposure to smoke?
Has you heart been checked with an EKG?
When did these symptoms start?
Any cough?
Customer: replied 7 years ago.
I had an echo done, it said that my PA is infact enlarged, almost twice the size that is normal. My doctor knows what the numbers are for my arteries but I don't, sorry. I have smoked from time to time but nothing as a habit or continous. I have a present cough that is always bothering me as well. I do biielive I had an EkG done but came back as normal.
Expert:  Dr. Muneeb Ali replied 7 years ago.
Ok thanks for the additional symptoms well enlargement of the pulmonary artery by itself is not something to wory about as there are a number of congenital anomalies which could lead to asymptomatic enlargement of the artery. But the important thing here is that you have the enlargement alongwith symptoms which can be consistent with that of pulmonary hypertension.

The shortness of breath which increases on exertion and the fact there is high pulse rate and increased coughing all point towards the diagnosis. In addition since you have had the echo this would have shown the increased PAP which is pulmonary artery pressure. Now what is the cause for this? at such a young age the cause is ually congenital anamoly of the artery which leads to its enlargementor even collagen vascular diseases such as scleroderma etc which leads to gradual thickineing of the artery due to deposition of fibrous material and thus leads to the enalrgement of the pulmonary artery. yet another rare cause is that of an idipathic pulomart artery aneurysm which should be picked up on a CT scan of the chest. This is a very rae cause and studies have shown this to occur in young patients as well. Im mentioning this here because if no other cause is found then this should be considered. Ill paste a link here for a study regarding this last condition,

http://www2.umdnj.edu/~shindler/padil.html

You can show this to your doctor and ask for his opinion on this.

Now the other causes of PAH (pulmonary artery hypertension) like collagen vascular diseases or vasculitis must be ruled out with tests like ESR, ANA, CRP, ANCA etc etc. This can be done if you have any other evidence of the disease. If you dont have any cause which can be found then this will be termed as idipathic hypertension.

Now the treatment for this is varied and depends on the pressure and the symptoms as well,

This includes,

Diuretics like lasix
Vasodilators like calcium channel blockers (procardia)
Sildenafil (viagra)
Epoprostenol which also dilates the arteries and reduce the pressure
Bosentan

the important point here is that treatment needs to be started early and to prevent the occurence of failure of the right side of the heart. Here is some more information on this conidtion,

http://my.clevelandclinic.org/disorders/pulmonary_hypertension/hic_pulmonary_hypertension_causes_symptoms_diagnosis_treatment.aspx


http://www.medicinenet.com/pulmonary_hypertension/article.htm

I hope this helps you out

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