A Pulmonologist is a phyiscian specializing in the diagnosis and treatment of pulmonary (respiratory tract/lung) diseases including primary pulmonary hypertension. Generally, patients are referred to them by primary care givers when either they develop respiratory difficulties of an undetermined origin or abnormalities of the pulmonary system that are detected through x-ray, or other chest imaging.

Typically, the first visit to the pulmonologist begins with a thorough review of the patient's medical history and pulmonary symptoms followed by a physical examination. If a pulmonologist suspects primary pulmonary hypertension he or she will order a chest X-Ray, to create an image of the chest cavity. If the radiograph is inconclusive than generally the pulmonologist will order a heart catheterization. A heart catheterization is a much more invasive procedure and involves running special catheters through major veins of the body and into the pulmonary artery. Once inside the artery the catheter may conduct extremely precise hemodynamic (blood pressure) measurements.

Once a patient is diagnosed with Primary Pulmonary Hypertension, the pulmonologist works closely with the patient's primary care provider. The Pulmonologist is responsible for discussing treatment options with the patient, administering treatment, monitoring the patients progress, and assessing the success of the treatment.

Aside from dealing with Primary Pulmonary Hypertension, Pulmonologists also diagnose and manage asthma, emphysema, chronic bronchitis, obstructive sleep, apnea, sarcoidosis, occupational lung disease, pneumonia, lung, cancer and tumors, respiratory failure, and idiopathic pulmonary fibrosis. Because of the diverse knowledge and skill required to properly diagnosis and treat these various conditions, a pulmonologist, considered an internal medicine subspecialist, requires extensive training.

After completing a four year graduate medical degree, the Pulmonologist must also complete three years of accredited internal medicine residency, followed by an additional two years of full-time graduate training in the subspecialty of pulmonary science. During this training, the pulmonologist candidate is required to pass not only one board certification exam, but two; the Board of Internal Medicine, after residency, and the Board of Pulmonary Medicine, after completion of the pulmonary science subspecialty training.

These physicians are also expected to have broad experience and competence in the treatment and management of critically ill patients, as well as experience in other areas of medicine, such as cardiology, endocrinology, and infectious diseases.

Although Pulmonologists are well trained physicians, most do not specialize in treating PH patients. Most major cities have a doctor who specializes in the treatment of PH patients, that physician is usually a pulmonologist or cardiologist. Ask your physician if they have experience with Pulmonary Hypertension, which is very rare disease that usually requires an expert in the area.



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