This unit has been developed to provide optimal care for patients with pulmonary hypertension (PH) as it is recognised that optimal care requires a close working partnership between the patient, thoracic physician, cardiologist and if involved the rheumatologist and haematologist.

The Wesley Hospital is now a designated Australian treatment centre for PH and has Federal Government funding for medications including parenteral, inhaled and oral vasoactive agents that act as pulmonary vasodilators to treat PH. These agents also have antithrombotic, antifibrotic and antimitogenic properties. Monotherapy or combination therapy will be trialled in conjunction with centers in Australia and overseas.

The majority of affected patients will have disorders involving the lung, heart, connective tissue, liver and genetic disorders. Sleep disorders, obesity, pulmonary thromboembolic disorders, some chemotherapy agents, thyroid disorders are also significant contributing causes within Australasia. For this reason we appreciate the support and guidance of our specialist colleagues in these areas.

The team will involve Dr John Feenstra, Thoracic and Sleep Physician, Dr Andrew Scott, Thoracic and Sleep Physician, and Dr David Cross, Cardiologist. Our unit is assisted by Dr Fiona Kermeen, Thoracic and Transplant Physician, The Prince Charles Hospital Pulmonary Hypertension and Transplant Unit.

Both Dr Feenstra and Dr Scott have trained in PH at The Prince Charles Hospital Unit. Dr Scott has also worked at the St. Vincent’s Hospital Unit (Sydney) and Papworth Hospital Unit (Cambridge, U.K.). Dr Cross has been actively involved in cardiac research involving pulmonary hypertension for many years at The Wesley Hospital and The Royal Brisbane Hospitals.

The establishment of The Wesley Pulmonary Hypertension Clinic will allow your patient(s) a dedicated clinical pathway for the assessment and management at The Wesley Hospital.

Contact Us

Enquries and referrals can be directed to:

Dr John Feenstra

What is Pulmonary Hypertension?

Pulmonary Hypertension (PH) is the medical term for a unique disease process which takes place in the small vessels which carry blood from the heart to the lungs (the "pulmonary arteries and or arterioles"). Although it is uncommon, it is a disease that can affect males and females of all ages and ethnic backgrounds. Although rare, a small number of cases are seen in younger age groups.

The disease process in the pulmonary arteries which leads to PH occurs over several years. The signs and symptoms of this disease are often hard to distinguish from other diseases or conditions, particularly in the early stages. This frequently delays the formal diagnosis of PH.

This disease process severely restricts the flow of blood from the heart to the lungs, which increases the pressure in the pulmonary arteries. The heart must pump against this increased pressure to maintain blood flow to the lungs and then to the rest of the body.  The heart eventually fails to pump efficiently and as a result eventually may fail completely.

During this time, symptoms such as tiredness and breathlessness are experienced. Understandably, these can impact greatly on daily life. Eventually fluid can build up in the legs and patients may experience dizziness or light headedness on walking.

Types of Pulmonary Hypertension

PH can be associated with several different diseases, including:

Pulmonary Hypertension can also occur following blood clots in the lung or in association with chronic lung diseases. Although there are many similarities between these conditions and with PH, there are also significant differences.

Pulmonary Hypertension can also occur without obvious association and sometimes there is a familial predisposition (ie. it may be seen in several members of the same extended family). These forms of PH are known as idiopathic PH and familial PH. These terms have replaced the previous term of primary pulmonary hypertension (PPH).

Symptoms of Pulmonary Hypertension

Some of the early symptoms of PH include:

Often, people do not take much notice of these early signs of PH. They may think they are just over-tired or lacking in fitness.

As the disease progresses, the symptoms become more noticeable. Breathlessness and tiredness become more a part of daily life, so that even simple tasks, such as getting dressed and walking short distances, become increasingly difficult. Fluids can build up in the legs and chest pain may also be experienced. These are all signs of the increased stress being placed on the heart as it attempts to adjust to the disease's effects on the body's heart-lung blood flow functioning.

It is usually when these symptoms severely affect normal activities of daily life, that people go to their doctor to identify the cause.  PH is an uncommon disease with early symptoms that are easily confused with those of other conditions, such as asthma, and may be incorrectly treated on this basis.  Further, the symptoms may be dismissed as due to stress or a lack of fitness, there is often a delay before a doctor is even consulted.  As a result, the path to a confirmed diagnosis of PH can take several years from the time of the first symptoms, while other possibilities are eliminated.

Diagnosis of Pulmonary Hypertension

History: To assist in the diagnosis of PH, we need to gain a clear and detailed history of all prior and current medical conditions, and those of close relatives.

Medication: Additionally, we needs to know of any drugs (be they prescription, over-the-counter or illegal) that have been taken in the past, or are currently being taken.

Tests: Blood tests and a physical examination should be conducted and subsequently further tests could be required to accurately identify PH. Further testing is due to diagnosis usually resulting from ruling out the presence of other diseases which may have similar symptoms to PH.

An echocardiogram (ultrasound of the heart) is required and if there is a suggestion of PH, then other tests including lung function tests and 6 minute walking tests, CT scans of the lungs and a right heart catheter may also be required.

Doctors who treat this condition have devised a grading system to help understand to what extent the PH symptoms are affecting lifestyle and well-being. This is referred to as a PH "functional class", and helps the relevant specialists know what type of treatment can be given. This functional class system classifies how severe the PH is, based on the symptoms. It is graded from class I through to class IV, where class I is very early stage PH and a functional class of IV is very severe PH.

Treatment of Pulmonary Hypertension

Without treatment, the outlook for patients with PH is extremely guarded. However, there are now several good treatments available. These can vary from tablets to nebulisers and at the very severe end of the spectrum, continuous intravenous infusion.

Most patients do very well with this treatment but occasionally and only if these treatments are ineffective, more involved treatments including lung transplantation may need to be considered. Links are therefore in place with the Queensland Lung Transplant Unit and Pulmonary Hypertension Unit at The Prince Charles Hospital.

As PH is uncommon and its treatment complex, all patients with PH should be managed by an experienced centre.

The Wesley Hospital Pulmonary Hypertension Clinic is now an accredited site for treatment with the Federal Government.

Systemic Sclerosis Associated with Pulmonary Hypertension