Pulmonary Hypertension Expert Forum
What does this chest x-ray mean?
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Pulmonary hypertension is a condition associated with high blood pressure in the arteries that connect your heart with your lungs. It is a serious condition for which there are many emerging treatments but no definite cure. In this disease, the blood vessels that carry oxygen-poor blood from your heart to your lungs become hard and narrow, which causes your heart to work harder to pump the blood. This forum is a place to ask questions about Pulmonary Hypertension. Some examples are: What caused me to get pulmonary hypertension? How is pulmonary hypertension diagnosed? What treatment options are available?

IMPORTANT!! If you have a question that requires immediate medical attention, or if you think you may have an emergency situation, please call your doctor or 911 IMMEDIATELY!

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What does this chest x-ray mean?

My mom who is 65 had a chest x-ray and can't get an appt. to see her pulmonary dr. for weeks.  She's been having difficulty breathing and gets winded quickly.  She smoked 40 years ago for about 5 years.  She was also exposed to second-hand smoke for years (dad).  She gets bronchitis frequently.

Her x-ray stated "pulmonary hypertension, hyperaerated lung fields with a mild increase of interstial markings possibly indicated COPD or Emphysema with a PAS change from 25-61 in one year."

This sounds scary and she is stressing because her appt. isn't for a while.  Could you explain any of this in simpler terms?  Thanks so much.
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1884349_tn?1353818598
Hi there and welcome to the forum.

First, a chest x-ray, while a helpful diagnostic test in certain circumstances, is also often somewhat “non-specific” and some of the findings seen on the chest x-ray may be true-true but unrelated to a person’s symptoms.  Although a chest x-ray can suggest the presence of pulmonary hypertension (i.e. if large pulmonary arteries are visualized), this is never the appropriate way to make such a diagnosis.  

In your mother’s case, her long exposure to cigarette smoke certainly puts her at risk for having COPD (which causes shortness of breath) and chest x-ray findings tend to be much more specific for the diagnosis of COPD than pulmonary hypertension.  However, dedicated pulmonary function tests (also called PFTs) will be much more helpful than the chest x-ray (I suspect her pulmonary doctor will order this test).  If COPD is indeed the diagnosis, there are treatments available that will likely improve her symptoms.  Although pulmonary hypertension can also occur with COPD, in most instances it is mild (and again, one can’t use the CXR to make the diagnosis).

Second, please remember that one should never wait for a doctor’s appointment if symptoms become too severe---that is why we have emergency rooms!   I would not particularly fret over the chest x-ray results.  Your mom’s symptoms are far more indicative than anything the chest x-ray report says.  If she feels worse and cant make it to her doctor’s appointment, she should go to the ER.

Hope she feels better.

Dr. Rich


3 Comments
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Dr. Rich,

Thank you so much for your thoughtful response.  My mom actually was squeezed in today, but left with more questions than answers, unfortunately.

The specialist said he is confused as to why her PAS level is so high, yet her Blood Oxygen level is 100%.  He said that rarely happens if someone has lung and breathing issues.

Because of a family history of Rheumatoid Arthritis (her father), he is testing for connective tissue disorders: Lupus, RA, and ANA, stating that any autoimmune disorder can affect the lungs.  He is sending her for PFT tests, V/Q scan (to rule out blood clots) and a heart catheterization.  Needless to say, he really frightened her.

Besides the obvious heart cath, are any of the other diagnostic tests invasive?  

Again, I greatly appreciate you taking the time to explain this.

Regards.
Trenna

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1884349_tn?1353818598
Hi Trenna,

Among the tests you mentioned, only the heart catheterization is invasive.  I am sorry that she has been frightened but hopefully a diagnosis will be found soon and treatment to make her better will be initiated.

Good luck.

Dr. Rich
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1884349_tn?1353818598
Jonathan D. Rich, MDBlank
Northwestern Memorial Hospital
Chicago, IL
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