November 23, 2020
When Jordan Peoples (28) felt unshakable fatigue and shortness of breath, she chalked it up to being slightly out of shape. A camp counselor in Kerrville, TX, Jordan recalls the exact moment she realized her health was not quite right when she was taking a group of campers for a strenuous hike in January of 2019. She considered herself a decently skilled hiker, though she and some fellow counselors stayed in the back of the group to ensure everyone could keep hiking without interruptions. Every few steps, Jordan would find herself stopping, trying to catch her breath. Her friends at the tail end were keeping a moderate pace, and she was still unable to keep up.
By April, Jordan had gained nearly fifteen pounds and really noticed a constant shortness of breath. She tried getting her weight gain under control, though walking up hills or exerting in exercise became difficult for her. “It got to the point where my coworkers at camp noticed I didn't look like myself. ‘You look pale and in pain’ they would comment,” she remembered.
Jordan started experiencing sharp abdominal pains that coincided with her shortness of breath and knew something was wrong. She went to the Peterson Regional Medical Center emergency room in Kerrville where they performed several tests. Her results came back normal and she was discharged home. Jordan followed up with her primary care physician; with possible concerns for thyroid or heart conditions, her physician ran a brain natriuretic peptide (BNP) test, a blood test that measures levels of proteins made by heart and blood vessels.
Jordan went home that evening, and within hours received a call that changed her life forever. “They called me that night and said I need to get to the ER right away, that I was going into heart failure,” she recalls.
Jordan's care team immediately performed a right heart catheterization (RHC) to measure her pulmonary artery pressures. RHCs are performed by navigating a catheter into the chambers of the right heart as well as the pulmonary arteries. If the tiny arteries in the lungs become narrow or blocked, it becomes difficult for blood to flow through them. If this occurs, blood pressure in the lungs rise and pressure is put on the heart to work harder to pump blood through the arteries, often weakening the heart muscle, eventually leading to heart failure.
This was the case for Jordan. She was diagnosed with pulmonary hypertension (PH), a type of high blood pressure in the arteries that goes from the heart to the lungs. This disease disproportionately affects women in their 20s, 30s, and 40s—young women who seem unlikely candidates for lung or heart disease.
Jordan's cardiologist and pulmonologist at Peterson Regional Medical Center knew she needed expert care and transferred Jordan to Methodist Hospital under the care of Michael Kwan, MD, Advanced Heart Failure Cardiologist and Charles Burch, MD, Critical Care Pulmonologist.
“Jordan's ECHO and cardiac catheterization tests demonstrated severe right heart failure and pulmonary hypertension. The condition is fatal if not recognized and treated, so it was very fortunate that she transferred to us as quickly as she did,” commented Dr. Burch.
Jordan was treated with endothelin receptor antagonists (ERAs) and Phosphodiesterase 5 (PDE 5) inhibitors; these are targeted therapies used to treat people with pulmonary hypertension to slow the progression of the disease and help reverse some of the damage to the heart and lungs. Jordan's condition markedly improved. She was discharged home on oxygen and returned to work and full activity. Earlier this year, Jordan began experiencing symptoms of chest pain again and came back to the hospital for evaluation. Her ECHO test showed progression of the disease, and she was hospitalized for further treatment.
“There is no cure for pulmonary hypertension, but today's medications work exceptionally well to stabilize the disease so patients can live normal lives,” commented Dr. Burch. “Receiving this diagnosis is life-changing. It requires frequent visits to the clinic and tests to ensure the stability of heart and lung function. A small number of patients can progress despite treatment and may eventually require a lung transplant.”
While it can be difficult to imagine in the days and months following diagnosis, many patients develop strategies to cope with the physical and emotional aspects of living with PH. By understanding the dynamics of the disease and having flexibility and patience, many people affected by pulmonary hypertension find ways to work, travel, exercise, and do the things they loved before they were diagnosed. Jordan has since found ways to manage her disease and does not let it hinder her time spent outdoors doing the things she loves.
To learn more about pulmonary hypertension and lung care at Methodist Hospital, visit SAHealth.com/specialties/pulmonary-care