The Royal Free London is a national centre for diagnosis and treatment of pulmonary arterial hypertension (PAH). We are integrally linked with the connective tissue disease service at the Royal Free Hospital and enjoy close links with the interstitial lung disease service at the Royal Brompton Hospital. We have wide experience in all types of pulmonary hypertension and provide support to other centres in the UK.
What is pulmonary hypertension?
Watch our short film which explains what pulmonary hypertension is (duration 4:40).
Pulmonary hypertension is defined by a high pressure in the pulmonary arteries (25 mmHg or above). The most common causes are left heart disease (systolic or diastolic dysfunction or severe valvular disease), hypoxic lung disease (such as interstitial lung disease or COPD) or pulmonary emboli.
Pulmonary arterial hypertension on the other hand is an uncommon group of diseases where the pulmonary hypertension is due to disease of the pulmonary arterioles. The principal causes of pulmonary arterial hypertension are:
- Idiopathic – often found in young women.
- Connective tissue disease – most commonly scleroderma and scleroderma overlap.
- Congential heart disease – in association with Eisenmenger’s syndrome.
- Rare causes – there are many, including cirrhosis with portal hypertension, HIV, Schistosomiasis, sickle cell disease and use of slimming tablets like fenfluramine.
Although this distinction between pulmonary arterial hypertension (PAH) and pulmonary hypertension (PH) is pivotal in deciding treatment options, the terms are often used interchangeably particularly when talking to patients.
Pulmonary hypertension is a sequel of pulmonary emboli in 2-4% of cases. This can sometimes be treated with surgical removal of the occlusive material. Although not strictly part of PAH, the investigations and management overlap so these patients are also managed by pulmonary hypertension specialists.
Do you have an appointment?
The Royal Free Hospital
Telephone: 020 7472 6354
At the Royal Free London we are pleased to see any patient suspected of having pulmonary hypertension.
Patients who are breathless usually undergo investigations including an ECG, echocardiography, pulmonary function tests, chest x-ray and if necessary a CT chest scan before being referred for consideration of pulmonary hypertension.
Pulmonary hypertension should be considered in patients with unexplained progressive breathlessness, unexplained right heart failure or exertional presyncope or syncope. It should be considered particularly in patients with conditions that can predispose to pulmonary hypertension such as congenital heart disease, connective tissue disease, liver failure, pulmonary emboli and HIV.
If you are a GP or other health professional and would like to refer us a patient, please send a letter together with these investigation results to us. In urgent cases, please contact the pulmonary hypertension fellow or cardiology registrar on call to discuss the case with us.
Dr Gerry Coghlan
Phone number: 020 7794 0500 ext 33614/38648/31188
Email address: Gerry.email@example.com
Private practice phone number: 01895 811 153
Professor Clive Handler
Consultant in pulmonary hypertension
Email address: firstname.lastname@example.org
PA/secretary phone number: 020 7794 0500 ext 35893
Fax: 020 7317 7747
Dr Benjamin Schreiber
Consultant in pulmonary hypertension and rheumatology
Phone number: 020 375 82042
Email address: email@example.com
PA/secretary email address: 020 375 82042 + option 2
Fax: 020 7317 7747
Read our patient leaflets and publications
Tele medicineclinics and email helpline for pulmonary hypertension patients (Large Print)
.pdf (159 KB)
Selexipag (Uptravi®) Information for patients (Large Print)
.pdf (182 KB)
The cardiac catheter test for pulmonary hypertension (Large Print)
.pdf (173 KB)
Exercise and keeping fit with pulmonary arterial hypertension
.pdf (168 KB)
Cardiac catheter test for pulmonary hypertension
.pdf (134 KB)
Medicines information: Selexipag
.pdf (181 KB)
Telemedicine clinics and email helpline for pulmonary hypertension patients
.pdf (156 KB)
Contacting the pulmonary hypertension service
.pdf (299 KB)
Your first appointment - Pulmonary hypertension service
.pdf (742 KB)