Medical Rounds with Dr. Dina Darsaklis

Medical Rounds with Dr. Dina Darsaklis


– Tonight in Medical Rounds. If you have pulmonary hypertension, you want to pay close
attention to this interview. All this month is dedicated to awareness of pulmonary hypertension. It’s a type of high blood pressure that affects the arteries and the lungs, and on the right side of the heart. And joining us live tonight
is Dr. Dina Darsaklis. She’s cardiology director of Pulmonary Vascular Disease
at Hartford Hospital. Good evening, Dr. Darsaklis.
Thanks for joining us tonight. – Good evening, Denise. – First of all, how does this happen? How do the arteries become so
thick and narrow in the lungs? – That’s really a great question. Scientists actually don’t fully understand at this point in time what causes it. But what we do know is that
the very small arteries that feed the lung tissue
called pulmonary arterials, the vessel wall of those
pulmonary arterials becomes thickened and inflamed. So this in turn causes
increase in resistance, and leads to what we refer
to as pulmonary hypertension. Now, downstream to these pulmonary vessels sits the right side of the
heart, the right heart. And as a resistance in
these vessels increases, patients develop right-heart failure and all the symptoms that
are associated with it. – Let’s talk about those symptoms. How do you know if you have
pulmonary hypertension, and how is it diagnosed? – So that’s a great question also. The symptoms of pulmonary hypertension in the very beginning
of the disease process, patients could have no symptoms at all to complaining of what we call dyspnea, which is shortness of breath. And this is a very common symptom present in many different disease processes. However, as a disease process progresses and patients develop right-heart failure, then patients can start
developing symptoms such as dizziness, palpitations, swelling around the abdominal area, the belly area, as well as the legs. – So what do we do about
this, Dr. Darsaklis? What are the treatment options available? – So we have quite a few different treatment options available. And this ranges from inhaled medications to oral medications to external pumps, with continuous medications running either under the skin or intravenously. All these medications basically dilate the pulmonary vessels, so to decrease the resistance
in the pulmonary bed and so decrease the
pulmonary hypertension. – That sounds good. We have a few seconds left and I always like to ask,
what’s on the horizon? What is out there? The next possible treatment? We understand there might be something. An implantable pump maybe next year? – That’s right. Approved in 2018, the FDA approved these implantable systems for Remodulin®, which is one of these
pulmonary vasodilators that dilates the pulmonary vessels. By being implanted, sitting
inside the patient’s body, this is a safer mechanism as well as delivers the medication in an
infection risk-free mechanism. The pumps so far are external and so this poses a safety risk for patients if the pump gets nicked because these continuous
medications cannot be stopped. Because if they’re stopped
for whatever reason, it becomes life-threatening
for the patient. And by being implanted, it’s
a lot safer for patients. – That sounds great. Thank you so much, Dr.
Darsaklis, for joining us tonight and for sharing that great information. For those of you at home,
if you want to learn more, just call the number
you see on the screen.

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