MedWatch Today: Fresno Pulmonary Hypertenion Program at Community Medical Centers


The Fresno Pulmonary Hypertension Program at Community Medical Centers is the only nationally accredited center in the Central Valley. It provides comprehensive medical care to those dealing with this very complex disease.

Pulmonologist Vijay Balasubramanian has been treating Gina Vazquez for nearly ten years. Dr. Bala, as he’s more commonly known, is the medical director of the pulmonary hypertension program. He explains, Gina was very sick when she was diagnosed with PH.

He said, “It is a very complex condition often very difficult to diagnose, and it is still considered a rare disease and it’s still in the National Registry of Rare Diseases.”

PH occurs when the small blood vessels in the lungs progressively narrow. That causes high blood pressure in the lungs and makes the right side of the heart work harder.

“Very common symptoms such as shortness of breath, feeling tired… leg swelling, chest pain, feeling dizzy when walking, sometimes people may faint when doing something strenuous… If the common things are ruled out like anemia, asthma, heart disease and things then at some point you need to start thinking in terms of, ‘Oh does this patient have pulmonary hypertension?'” commented Dr. Bala.

Gina had been experiencing nearly all those symptoms. She’s an artist and a poet and said her quality of life a decade ago was simply poor.

Gina said, “I was laying in bed and I would feel short of breath.”

The Turlock resident was referred to see Dr. Bala. He ordered tests, including one to confirm if she had PH.

“The ultimate test that actually confirms the diagnosis would be a test called right heart catheterization… Basically it’s a procedure where we insert a catheter through the internal jugular vein, goes into the right side of the heart into the lungs and we directly measure the pressures in the lungs,” stated Dr. Bala.

Gina added, “They checked the pressures, and the pressures were very high. They were very, very high, like four times of what they should have been.”

Pulmonary hypertension is unfortunately not curable, but treatable.

“I had to start her on an injectable therapy, a special injectable therapy that’s a continuous pump that’s administered through a continuous pump under the skin,” said Dr. Bala.

Gina continued, “It’s a needle and it goes under your skin and then you tape the pump to your stomach or wherever you decide to have it done and it gives medication continuously.”

Dr. Bala said newer therapies have emerged over the last two decades that have dramatically influenced the management of this challenging condition. Current treatments help to open up the small blood vessels in the lungs. Gina has since moved to an oral form of the intravenous medication she’s been receiving for years. She said it has been life changing to manage her PH.

Gina said, “It was touch and go for a long time if I had not found Dr. Bala. I saw him in March of 2011, I wouldn’t have made it through summer I’m sure of it. I was very, very, very ill… I’m grateful for his skill, I’m grateful for his commitment to excellence, because that’s very important to him. He stays on top of things, he makes sure he knows about clinical trials that are going on what’s new in the field.”

The pulmonary hypertension program also provides a support group setting for patients and caregivers. Gina has been very involved in the PH community and even corralled other patients to collaborate on creating this beautiful piece of art. You can check it out in the Trauma Center lobby at Community Regional Medical Center.

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