Teamwork is Key in Pulmonary Hypertension Clinic
A pediatric heart specialist and pediatric lung specialist at Children’s Hospital & Medical Center in Omaha have grown accustomed to collaborating over the last year, working closely together in a crucial space where where their two disciplines intersect.
Scott Fletcher, MD, medical director, Cardiovascular MRI and Exercise, and Paul Sammut, MD, clinical service chief, Pediatric Pulmonology, partnered in early 2013 to launch the Pulmonary Hypertension Clinic.
“Dr. Sammut and I visit the patients together. Families hear us speak one after another. I’m listening to Dr. Sammut and Dr. Sammut is listening to me as the family is listening to both of us,” says Dr. Fletcher. “We speak with a more common voice, and our care is much more coordinated than it would be if there was one cardiologist seeing patients independently and one pulmonologist seeing patients independently. That is not optimal. Teamwork is critical.”
Progressive and potentially fatal, pulmonary hypertension (PH) is a type of high blood pressure that can affect the arteries in the lungs and the right side of the heart. Some estimate as many as 20 percent of patients going into adulthood who have had corrected congenital heart disease have some component of PH.
Diagnosis begins with an echocardiogram. If PH is suspected, the gold standard treatment is cardiac catheterization.
“If we get to patients early on, we have a much better chance of keeping them from progressing to the severest forms of the disease,” Fletcher says.
The Pulmonary Hypertension Clinic is held the third Wednesday of the month. The team also includes a pulmonology nurse and a cardiology nurse. In addition to treating pediatric PH patients, both in-clinic and those admitted to the hospital, Drs. Fletcher and Sammut feel it is their job to raise awareness of PH among their colleagues.
“We really feel that we have come across some children who would have died without the recognition of the problem and adequate treatment,” Dr. Sammut says. “Many have had resolution of symptoms, and that’s very gratifying.”