Leading expert in pulmonary arterial hypertension and heart failure, Dr. Aaron Waxman, MD, explains the complexities of shortness of breath diagnosis. He details the common misdiagnosis of conditions like pulmonary hypertension and HFpEF. Dr. Waxman's research focuses on inflammatory mechanisms in pulmonary vascular disease. His work has resulted in over 150 peer-reviewed publications.
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Understanding Pulmonary Arterial Hypertension and Heart Failure with Preserved Ejection Fraction
Jump To Section
- What is Pulmonary Arterial Hypertension?
- Recognizing Symptoms of PAH
- Common Causes of Pulmonary Hypertension
- The Challenge of HFpEF Diagnosis
- Research Focus on Vascular Remodeling
- Expert Background and Credentials
- Full Transcript
What is Pulmonary Arterial Hypertension?
Dr. Aaron Waxman, MD, defines pulmonary arterial hypertension (PAH) as a specific type of high blood pressure. This condition affects the arteries in the lungs and the right side of the heart. PAH involves the narrowing and blocking of small lung arteries. This increases pressure and forces the heart to work harder.
The increased workload can lead to right heart failure over time. Dr. Aaron Waxman, MD, emphasizes that PAH is a serious, progressive disease. It requires expert diagnosis and specialized management strategies.
Recognizing Symptoms of PAH
Shortness of breath is the hallmark symptom of pulmonary arterial hypertension. Dr. Aaron Waxman, MD, notes this symptom often occurs during routine physical activity. Patients may also experience fatigue, chest pain, or a racing heartbeat.
Dizziness and fainting spells are other critical warning signs. Swelling in the ankles, legs, or abdomen can indicate advancing heart failure. Dr. Waxman stresses that these symptoms are frequently mistaken for more common conditions like asthma.
Common Causes of Pulmonary Hypertension
Pulmonary hypertension has multiple potential causes. Dr. Aaron Waxman, MD, explains that idiopathic PAH has no known cause. Heritable genetic mutations account for a portion of cases. Connective tissue diseases like scleroderma are a significant associated condition.
Congenital heart disease and chronic liver disease can also lead to PAH. Dr. Waxman's expertise includes thromboembolic disease, another major cause. This refers to chronic blood clots in the lungs that elevate pressure.
The Challenge of HFpEF Diagnosis
Heart failure with preserved ejection fraction (HFpEF) is a frequent source of diagnostic confusion. Dr. Aaron Waxman, MD, highlights that HFpEF is a common mimic of pulmonary hypertension. Patients present with identical symptoms like severe shortness of breath.
This condition is notoriously difficult to diagnose accurately. It requires a comprehensive evaluation to distinguish it from PAH. Dr. Waxman's work at Brigham and Women's Hospital focuses on this precise differential diagnosis.
Research Focus on Vascular Remodeling
Dr. Aaron Waxman, MD, directs his research toward understanding pulmonary vascular remodeling. His work investigates the inflammatory mechanisms that drive disease progression. This process involves changes in the structure of blood vessel walls.
These changes lead to increased resistance and pressure in the lung circulation. Dr. Waxman's research, including his time at the Howard Hughes Medical Institute, aims to uncover new therapeutic targets. This work is crucial for developing better treatments for right heart failure.
Expert Background and Credentials
Dr. Aaron Waxman, MD, is a highly credentialed specialist in pulmonary vascular disease. He is an Associate Professor of Medicine at Harvard Medical School. Dr. Waxman serves as the Executive Director of the Center for Pulmonary Heart Diseases.
He also directs the Pulmonary Vascular Disease Program at Brigham and Women's Hospital. Dr. Waxman earned his MD from Yale University School of Medicine. He completed his residency and pulmonary fellowship at Yale New Haven Hospital.
Dr. Anton Titov, MD, interviewed Dr. Waxman to share this critical expertise. Dr. Waxman's extensive publication record includes over 150 peer-reviewed articles. His presentations at international conferences have shaped the field of cardiopulmonary medicine.
Full Transcript
Dr. Aaron Waxman is one of the world’s top experts in shortness of breath differential diagnosis. Often shortness of breath is caused by pulmonary hypertension, or HFpEF, heart failure with preserved ejection fraction. It is a condition that is frequently misdiagnosed.
Dr. Anton Titov, MD: Hello from Boston! We are with Dr. Aaron Waxman, MD. He is Associate Professor of Medicine at Harvard Medical School. He is Executive Director of the Center for Pulmonary Heart Diseases and Director of the Pulmonary Vascular Disease Program at Brigham and Women's Hospital in Boston.
Dr. Waxman obtained his MD from Yale University School of Medicine and his PhD from Albany Medical College in New York. He did residency training in medicine at the Yale New Haven Hospital and a fellowship in pulmonary and critical care at the Yale New Haven Hospital. Dr. Aaron Waxman, MD, did research at the Howard Hughes Medical Institute.
Dr. Waxman's clinical and research interests include pulmonary arterial hypertension, right heart failure, thromboembolic disease, and pulmonary vascular disease. His research focuses on the inflammatory mechanisms of pulmonary vascular remodeling that lead to right heart failure.
Dr. Aaron Waxman, MD, has authored and co-authored over 150 peer-reviewed publications in international medical journals and presented numerous talks at international conferences on heart and lung disease.
Dr. Anton Titov, MD: Dr. Waxman, thank you and welcome!
Dr. Aaron Waxman, MD: Thank you!
Dr. Anton Titov, MD: What is pulmonary arterial hypertension? How to recognize its symptoms? What are some of its causes?